Multiplanar correction of proximal tibial recurvatum deformity with tibial osteotomy and computer assisted fixator

Background: Several treatment modalities including open wedge osteotomies and Ilizarov reconstruction have been described for treatment of Proximal tibial recurvatum (PTR). However, the literature lacks information regarding the multiplanar correction of PTR using the computer assisted hexapod external fixator. The aim of the study is to present the results of PTR treatment with a computer assisted fixator systems. Methods: There were three female and three male patients (10 lower extremities) with a mean age of 20.6 years (7.3 to 25.2y) in the study group. The angle of genu recurvatum (aGR), the tibial plateau tilt angle (aTP), the mechanical posterior proximal tibial angle (mPPTA) and sagittal mechanical axis deviation (MADs) was measured for the sagittal plane assessment. Results: Preoperative sagittal assessment showed that the mean aGR was 28.9 degrees +/- 6.8 degrees, mean aTP was 64.5 degrees +/- 10.2 degrees and mean mPPTA was mPPTA was 114.1 degrees +/- 10.3 degrees. At the final follow-up there was a significant correction (p < 0.05 for aGR, aTP and mPPTA). Mean MADs was improved from 66.1 +/- 14.2 mm to 16.6 +/- 5.1 mm (p:0.005). Mean A:B ratio was 0.92 +/- 0.13 preoperatively and 0.89 +/- 0.14 postoperatively (p:0.37). Nine out of 10 knees had valgus deformity and mean preoperative tibiofemoral anatomic angle (TFA) was improved from 10.8 degrees +/- 3.7 degrees valgus to 6.5 degrees +/- 1.7 degrees valgus. Conclusion: The treatment of PTR deformity with a computer-assisted hexapod external fixator is safe and effective. It provides multiplanar correction of the deformity with a high precision and the patellar alignment remains stable during the correction. (c) 2021 Elsevier B.V. All rights reserved.

Automated summary

The study demonstrated that treating PTR deformity with a computer-assisted hexapod external fixator is safe and effective, providing multiplanar correction with high precision while maintaining stable patellar alignment during the correction process.