Randomized Comparative Study in the Correction of Upper Tibial Varus Deformity by Percutaneous Upper Tbial Osteotomy and Casting Versus TomoFix Plate | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 60, Issue 3, September 2025, Pages 248-256 PDF (607.27 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EOJ.2025.449740 | ||
| Authors | ||
| Alaa M. Ali* ; Mohamed M. Hegazy; Ahmed S. Hassen | ||
| Department of Orthopedic Surgery, Faculty of Medicine, Helwan University, Helwan, Egypt. | ||
| Abstract | ||
| Background Genu varum causes anatomical abnormalities in musculoskeletal alignment. The proximal tibial opening wedge osteotomy procedure is effective for treating medial compartment overload. This study aimed to compare between opening medial wedge upper tibial osteotomy (UTO) done with locking plate fixation (TomoFix) versus percutaneous upper tibial transverse osteotomy and casting as a definitive management of upper tibial genu varus deformity. As regards deformity correction, cosmesis, healing, and functional outcome. Patients and Methods A randomized clinical trial included 38 limbs with tibial varus deformity, who were randomly classified into two groups (19 limbs in each group): medial opening wedge UTO performed with locking plate TomoFix group (group A) and percutaneous transverse UTO and above knee casting (group B). During the follow-up duration, all patients underwent general examinations, local examinations, and radiological assessments. Certain angles were assessed including mechanical axis deviation, tibiofemoral angle, and medial proximal tibial angle. Functional outcome was evaluated utilizing the Bostman knee score and knee society scoring system. Patients’ satisfaction and postoperative complications were reported. Results There was a substantial enhancement in mechanical axis deviation, medial proximal tibial angle, lateral distal femoral angel, and tibiofemoral angle in both groups postoperatively. There was no substantial variance between groups concerning postoperative angles. Posterior tibial slope decreased after percutaneous transverse UTO. The rate of undercorrection was elevated in group B than in A. There was no substantial variation between the two groups concerning preoperative and postoperative Bostman knee score, postoperative patients’ satisfaction, and knee society score. Conclusions The medial opening-wedge high tibial osteotomy plus TomoFix and percutaneous UTO plus casting produced favorable and consistent clinical and radiological results. | ||
| Keywords | ||
| Opening medial wedge upper tibial osteotomy; Percutaneous upper tibial transverse osteotomy; TomoFix; Upper tibial genu varus deformity; Upper tibial osteotomy | ||
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