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Femoral derotational osteotomy level does not effect resulting torsion

PURPOSE: The purpose of this study was to assess the effect on femoral torsion by rotational osteotomies at three different levels as measured in 3D using both the mechanical and the anatomic axes. METHODS: Ten cadaveric lower extremities underwent femoral osteotomies perpendicular to the anatomic a...

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Autores principales: Edmonds, Eric W., Fuller, Corey B., Jeffords, Megan E., Farnsworth, Christine L., Lindgren, Amelia M., Pennock, Andrew T., Upasani, Vidyadhar V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056778/
https://www.ncbi.nlm.nih.gov/pubmed/32130560
http://dx.doi.org/10.1186/s40634-020-00227-9
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author Edmonds, Eric W.
Fuller, Corey B.
Jeffords, Megan E.
Farnsworth, Christine L.
Lindgren, Amelia M.
Pennock, Andrew T.
Upasani, Vidyadhar V.
author_facet Edmonds, Eric W.
Fuller, Corey B.
Jeffords, Megan E.
Farnsworth, Christine L.
Lindgren, Amelia M.
Pennock, Andrew T.
Upasani, Vidyadhar V.
author_sort Edmonds, Eric W.
collection PubMed
description PURPOSE: The purpose of this study was to assess the effect on femoral torsion by rotational osteotomies at three different levels as measured in 3D using both the mechanical and the anatomic axes. METHODS: Ten cadaveric lower extremities underwent femoral osteotomies perpendicular to the anatomic axis (AA) at three levels: subtrochanteric, mid-diaphyseal and supracondylar. Parallel pins were placed, one in each femur segment. Computed tomography (CT) was acquired in post-osteotomies neutral position, then post-external rotation of the femur at each osteotomy level. Femurs were returned to neutral rotation between imaging exams. Using 3D CT reconstructions, custom software calculated femoral torsion (angle between the femoral neck axis and the posterior condylar axis in the transverse plane) and pin angle between segments, reoriented to both the mechanical axis (MA) and the AA. Pin angle and torsion change were compared for the three osteotomy locations (regression analysis and ANOVA performed). RESULTS: Two specimens were omitted (inadequate imaging); the remaining eight donors were 55–90 years old (mean: 64 ± 15 years), CT confirmed no bony defects. All three levels of osteotomy demonstrated significant correlations between the amount of rotation at the osteotomy (pin angle change) and the resulting change in femoral torsion (R square range 0.658–0.847). No significant differences were found between osteotomy level in torsion (MA:p = 0.285, AA:p = 0.156) or in pin angle (MA:p = 0.756, AA:p = 0.753). CONCLUSIONS: Performing a corrective rotational osteotomy orthogonal to the AA achieves the desired effect on MA regardless of location. This suggests that a surgeon’s osteotomy level choice may be based on other risks/benefits of the various techniques.
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spelling pubmed-70567782020-03-16 Femoral derotational osteotomy level does not effect resulting torsion Edmonds, Eric W. Fuller, Corey B. Jeffords, Megan E. Farnsworth, Christine L. Lindgren, Amelia M. Pennock, Andrew T. Upasani, Vidyadhar V. J Exp Orthop Research PURPOSE: The purpose of this study was to assess the effect on femoral torsion by rotational osteotomies at three different levels as measured in 3D using both the mechanical and the anatomic axes. METHODS: Ten cadaveric lower extremities underwent femoral osteotomies perpendicular to the anatomic axis (AA) at three levels: subtrochanteric, mid-diaphyseal and supracondylar. Parallel pins were placed, one in each femur segment. Computed tomography (CT) was acquired in post-osteotomies neutral position, then post-external rotation of the femur at each osteotomy level. Femurs were returned to neutral rotation between imaging exams. Using 3D CT reconstructions, custom software calculated femoral torsion (angle between the femoral neck axis and the posterior condylar axis in the transverse plane) and pin angle between segments, reoriented to both the mechanical axis (MA) and the AA. Pin angle and torsion change were compared for the three osteotomy locations (regression analysis and ANOVA performed). RESULTS: Two specimens were omitted (inadequate imaging); the remaining eight donors were 55–90 years old (mean: 64 ± 15 years), CT confirmed no bony defects. All three levels of osteotomy demonstrated significant correlations between the amount of rotation at the osteotomy (pin angle change) and the resulting change in femoral torsion (R square range 0.658–0.847). No significant differences were found between osteotomy level in torsion (MA:p = 0.285, AA:p = 0.156) or in pin angle (MA:p = 0.756, AA:p = 0.753). CONCLUSIONS: Performing a corrective rotational osteotomy orthogonal to the AA achieves the desired effect on MA regardless of location. This suggests that a surgeon’s osteotomy level choice may be based on other risks/benefits of the various techniques. Springer Berlin Heidelberg 2020-03-04 /pmc/articles/PMC7056778/ /pubmed/32130560 http://dx.doi.org/10.1186/s40634-020-00227-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Research
Edmonds, Eric W.
Fuller, Corey B.
Jeffords, Megan E.
Farnsworth, Christine L.
Lindgren, Amelia M.
Pennock, Andrew T.
Upasani, Vidyadhar V.
Femoral derotational osteotomy level does not effect resulting torsion
title Femoral derotational osteotomy level does not effect resulting torsion
title_full Femoral derotational osteotomy level does not effect resulting torsion
title_fullStr Femoral derotational osteotomy level does not effect resulting torsion
title_full_unstemmed Femoral derotational osteotomy level does not effect resulting torsion
title_short Femoral derotational osteotomy level does not effect resulting torsion
title_sort femoral derotational osteotomy level does not effect resulting torsion
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056778/
https://www.ncbi.nlm.nih.gov/pubmed/32130560
http://dx.doi.org/10.1186/s40634-020-00227-9
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