Treatment of Distal Femoral Valgus in Children and Adolescents Using Fixator Assisted Locking Plating (FALP)

Introduction: Correction of distal femoral valgus might be challenging task with significant morbidity. Treatment options are various and include osteotomy and external fixation, intramedullary nailing, and plating using a standard and locking plates. We described our experience with FALP technique during last 7 years in children and adolescent using minimally invasive fixator assisted locking plating.

Methods: During 2010-2016 we operated 13 patients (14 femurs) using FALP technique. There were 4 males and 9 females with median age 13.9 Years (range 9.8-26), with various conditions. All patients underwent correction using same protocol: two half pins were inserted from medial site of the thigh, 2 small incisions carried out and osteotomy was performed through distal incision. Correction was achieved after osteotomy by temporary external fixation and mechanical axis was examined using fluoroscopy. Plating of the femur was done using locking plate. Slight overcorrection was achieved in majority of cases.

Results: Intraoperative correction was achieved in all except one patient. Full weight bearing was started 6 weeks after the operation in all cases. Screw breakage was in one patient; none of the patient had wound or bone union complications.

Conclusion: Fixator assisted locking plate for distal femoral valgus is a safe , minimally invasive and very reliable technique