Cargando…

Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study

BACKGROUND: Soft tissue has an important role in stabilizing the hinge point of medial closed wedge distal femoral osteotomy (MCWDFO). However, there are conflicting data on the soft tissue anatomy around the hinge point of MCWDFO and, therefore, further anatomical data are needed. The purposes of t...

Descripción completa

Detalles Bibliográficos
Autores principales: Oda, Taiga, Maeyama, Akira, Yoshimura, Ichiro, Ishimatsu, Tetsuro, Miyazaki, Kotaro, Tachibana, Katsuro, Yoshimitsu, Kengo, Yamamoto, Takuaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9761968/
https://www.ncbi.nlm.nih.gov/pubmed/36536365
http://dx.doi.org/10.1186/s12891-022-06078-y
_version_ 1784852775880884224
author Oda, Taiga
Maeyama, Akira
Yoshimura, Ichiro
Ishimatsu, Tetsuro
Miyazaki, Kotaro
Tachibana, Katsuro
Yoshimitsu, Kengo
Yamamoto, Takuaki
author_facet Oda, Taiga
Maeyama, Akira
Yoshimura, Ichiro
Ishimatsu, Tetsuro
Miyazaki, Kotaro
Tachibana, Katsuro
Yoshimitsu, Kengo
Yamamoto, Takuaki
author_sort Oda, Taiga
collection PubMed
description BACKGROUND: Soft tissue has an important role in stabilizing the hinge point of medial closed wedge distal femoral osteotomy (MCWDFO). However, there are conflicting data on the soft tissue anatomy around the hinge point of MCWDFO and, therefore, further anatomical data are needed. The purposes of the study were to: 1) anatomically analyze the soft tissue around the hinge point of MCWDFO; 2) radiologically define the appropriate hinge point to prevent an unstable hinge fracture based on the result of the anatomical analysis; and 3) histologically analyze the soft tissue based on the result of the anatomical analysis. METHODS: In 20 cadaveric knees, the capsule attachment of the distal lateral side of the femur was marked with a radiopaque ball bearing. A digital planning tool was used to calculate the area of the marked capsule attachment around the ideal hinge point of MCWDFO on radiographs. The soft tissue around the hinge point was histologically examined and the periosteal thickness was measured and visualized graphically. The graph and radiograph were overlayed using image editing software, and the appropriate hinge position was determined based on the periosteal thickness. RESULTS: As a result, the periosteal thickness of the distal lateral femur tended to rapidly decrease from the metaphyseal region toward the diaphyseal region. The overlayed graph and radiograph revealed that the periosteal thickness changed in the region corresponding to the apex of the turning point of the femoral metaphysis in all cases. CONCLUSIONS: In conclusion, the periosteum might support the hinge of MCWDFO within the area surrounded by the apex of the turning point of the femoral metaphysis and the upper border of the posterior part of the lateral femoral condyle.
format Online
Article
Text
id pubmed-9761968
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-97619682022-12-20 Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study Oda, Taiga Maeyama, Akira Yoshimura, Ichiro Ishimatsu, Tetsuro Miyazaki, Kotaro Tachibana, Katsuro Yoshimitsu, Kengo Yamamoto, Takuaki BMC Musculoskelet Disord Research BACKGROUND: Soft tissue has an important role in stabilizing the hinge point of medial closed wedge distal femoral osteotomy (MCWDFO). However, there are conflicting data on the soft tissue anatomy around the hinge point of MCWDFO and, therefore, further anatomical data are needed. The purposes of the study were to: 1) anatomically analyze the soft tissue around the hinge point of MCWDFO; 2) radiologically define the appropriate hinge point to prevent an unstable hinge fracture based on the result of the anatomical analysis; and 3) histologically analyze the soft tissue based on the result of the anatomical analysis. METHODS: In 20 cadaveric knees, the capsule attachment of the distal lateral side of the femur was marked with a radiopaque ball bearing. A digital planning tool was used to calculate the area of the marked capsule attachment around the ideal hinge point of MCWDFO on radiographs. The soft tissue around the hinge point was histologically examined and the periosteal thickness was measured and visualized graphically. The graph and radiograph were overlayed using image editing software, and the appropriate hinge position was determined based on the periosteal thickness. RESULTS: As a result, the periosteal thickness of the distal lateral femur tended to rapidly decrease from the metaphyseal region toward the diaphyseal region. The overlayed graph and radiograph revealed that the periosteal thickness changed in the region corresponding to the apex of the turning point of the femoral metaphysis in all cases. CONCLUSIONS: In conclusion, the periosteum might support the hinge of MCWDFO within the area surrounded by the apex of the turning point of the femoral metaphysis and the upper border of the posterior part of the lateral femoral condyle. BioMed Central 2022-12-19 /pmc/articles/PMC9761968/ /pubmed/36536365 http://dx.doi.org/10.1186/s12891-022-06078-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Oda, Taiga
Maeyama, Akira
Yoshimura, Ichiro
Ishimatsu, Tetsuro
Miyazaki, Kotaro
Tachibana, Katsuro
Yoshimitsu, Kengo
Yamamoto, Takuaki
Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study
title Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study
title_full Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study
title_fullStr Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study
title_full_unstemmed Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study
title_short Soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study
title_sort soft tissue stabilization of the hinge position in medial closed wedge distal femoral osteotomy: an anatomical study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9761968/
https://www.ncbi.nlm.nih.gov/pubmed/36536365
http://dx.doi.org/10.1186/s12891-022-06078-y
work_keys_str_mv AT odataiga softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy
AT maeyamaakira softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy
AT yoshimuraichiro softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy
AT ishimatsutetsuro softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy
AT miyazakikotaro softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy
AT tachibanakatsuro softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy
AT yoshimitsukengo softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy
AT yamamototakuaki softtissuestabilizationofthehingepositioninmedialclosedwedgedistalfemoralosteotomyananatomicalstudy