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Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children

For proximal varus osteotomy of the femur in children, a stable fixation, is a concern regarding the safety and the protection of the surgery. The methods of fixation are mostly represented by plating systems; however, the tension band wiring is a simple and eligible option for fixation of proximal...

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Autores principales: Maranho, Daniel Augusto, Pagnano, Rodrigo Gonçalves, Volpon, José Batista
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602451/
https://www.ncbi.nlm.nih.gov/pubmed/25101990
http://dx.doi.org/10.1097/MD.0000000000000061
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author Maranho, Daniel Augusto
Pagnano, Rodrigo Gonçalves
Volpon, José Batista
author_facet Maranho, Daniel Augusto
Pagnano, Rodrigo Gonçalves
Volpon, José Batista
author_sort Maranho, Daniel Augusto
collection PubMed
description For proximal varus osteotomy of the femur in children, a stable fixation, is a concern regarding the safety and the protection of the surgery. The methods of fixation are mostly represented by plating systems; however, the tension band wiring is a simple and eligible option for fixation of proximal femur osteotomy. The purpose of this retrospective case series study is to evaluate outcomes and bone remodelation after using the tension band wiring technique to fixate proximal femoral varus osteotomies in children. The study enrolled 20 patients who underwent femoral varus osteotomy to treat Legg–Calvé–Perthes disease and other causes of necrosis of the femoral head. The mean patient age at the time of surgery was 7.4 ± 2.3 years (range, 4.3–13.8 y), and the follow-up period averaged 10 ± 4.3 years (range, 4.7–20.8 y). To assess the effects of the osteotomy at the neck-shaft angle and its evolution over time, radiographs obtained preoperatively and during the follow-up were analyzed. The neck-shaft angle was measured independently by 2 observers, and intraclass correlation coefficients (ICCs) were assessed for reliability. The ICC analysis showed good reliability. There was a significant reduction in the neck-shaft angle (P < 0.001) between the preoperative and the immediate postoperative periods, with an estimated difference of 14.3°. Between the immediate and the early postoperative periods, the estimated difference was 2.1°, which indicated a significant increase in the neck-shaft angle (P = 0.003). Between the early postoperative period and the final evaluation, there was a significant increase (P < 0.001), with an estimated difference of 7.0°. No implant failures or other complications were observed, but 1 case of peri-implant femoral fracture occurred >17 years postsurgery. The tension band wiring technique proved to be a simple and effective method for fixating proximal femoral varus osteotomy in children. The level IV is appropriated for our study (case series, retrospective).
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spelling pubmed-46024512015-10-27 Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children Maranho, Daniel Augusto Pagnano, Rodrigo Gonçalves Volpon, José Batista Medicine (Baltimore) Article For proximal varus osteotomy of the femur in children, a stable fixation, is a concern regarding the safety and the protection of the surgery. The methods of fixation are mostly represented by plating systems; however, the tension band wiring is a simple and eligible option for fixation of proximal femur osteotomy. The purpose of this retrospective case series study is to evaluate outcomes and bone remodelation after using the tension band wiring technique to fixate proximal femoral varus osteotomies in children. The study enrolled 20 patients who underwent femoral varus osteotomy to treat Legg–Calvé–Perthes disease and other causes of necrosis of the femoral head. The mean patient age at the time of surgery was 7.4 ± 2.3 years (range, 4.3–13.8 y), and the follow-up period averaged 10 ± 4.3 years (range, 4.7–20.8 y). To assess the effects of the osteotomy at the neck-shaft angle and its evolution over time, radiographs obtained preoperatively and during the follow-up were analyzed. The neck-shaft angle was measured independently by 2 observers, and intraclass correlation coefficients (ICCs) were assessed for reliability. The ICC analysis showed good reliability. There was a significant reduction in the neck-shaft angle (P < 0.001) between the preoperative and the immediate postoperative periods, with an estimated difference of 14.3°. Between the immediate and the early postoperative periods, the estimated difference was 2.1°, which indicated a significant increase in the neck-shaft angle (P = 0.003). Between the early postoperative period and the final evaluation, there was a significant increase (P < 0.001), with an estimated difference of 7.0°. No implant failures or other complications were observed, but 1 case of peri-implant femoral fracture occurred >17 years postsurgery. The tension band wiring technique proved to be a simple and effective method for fixating proximal femoral varus osteotomy in children. The level IV is appropriated for our study (case series, retrospective). Wolters Kluwer Health 2014-07-25 /pmc/articles/PMC4602451/ /pubmed/25101990 http://dx.doi.org/10.1097/MD.0000000000000061 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Article
Maranho, Daniel Augusto
Pagnano, Rodrigo Gonçalves
Volpon, José Batista
Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children
title Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children
title_full Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children
title_fullStr Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children
title_full_unstemmed Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children
title_short Tension Band Wiring for Proximal Femoral Varus Osteotomy Fixation in Children
title_sort tension band wiring for proximal femoral varus osteotomy fixation in children
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602451/
https://www.ncbi.nlm.nih.gov/pubmed/25101990
http://dx.doi.org/10.1097/MD.0000000000000061
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