Focal Dome Osteotomy Combined with Ilizarov Technique for Treating Femoral Multiplanar Deformity

Abstract

Objective The management of femoral multiplanar deformity remains a great challenge for orthopaedic surgeons. The focal dome osteotomy (FDO) combined with Ilizarov technique is a theoretically ideal method for treating femoral multiplanar deformity, but the clinical evidence is limited. The aim of this study is to assess the clinical and radiological outcomes of this combined strategy for correcting femoral multiplanar deformities. Methods A retrospective analysis was conducted to analyze 20 patients (29 limbs) with femoral multiplanar deformities treated by FDO combined with Ilizarov external fixation in our limb deformity center between 2017 and 2022. Preoperative and postoperative radiographical parameters were measured, including lateral proximal femoral angle (LPFA), mechanical lateral distal femoral angle (mLDFA), middle diaphysis angle (MDA), anatomic posterior distal femoral angle (aPDFA), mechanical axis deviation (MAD), and limb length discrepancy (LLD). Clinical assessments included a self‐made questionnaire for exercise capacity score (ECS), visual analog scale (VAS), and the 36‐Item Short‐Form Health Survey (SF‐36) score. Results There were eight males and 12 females, with a mean age of 32.8 years (14–61 years). All patients completed follow‐up with a mean follow‐up duration of 41.5 (27–81) months. The mean EFT was 8.9 (1.4–20.2) months. At final follow‐up, significantly improvement was noted regarding mean LLD (from 1.8 to 0.4 cm, p 0.5 cm) was noted in four patients but without significant symptoms. No serious complications occurred. Conclusions The strategy of FDO combined with Ilizarov fixation could provide powerful ability and good flexibility for correcting femoral multiplanar deformities without significant complications.

Keywords

• Correction
• Femoral Multiplanar Deformity
• Focal Dome Osteotomy
• Ilizarov Fixation