Treatment of Varus Deformities of the Lower Limbs in Patients with Achondroplasia and Hypochondroplasia
Ali Al Kaissi*, 1, 2, Sebastian Farr 2, Rudolf Ganger 2, Jochen G Hofstaetter 1 , 3 , Klaus Klaushofer 1, Franz Grill 2
Identifiers and Pagination:Year: 2013
First Page: 33
Last Page: 39
Publisher Id: TOORTHJ-7-33
Article History:Received Date: 30/7/2012
Revision Received Date: 17/12/2012
Acceptance Date: 19/12/2012
Electronic publication date: 8/2/2013
Collection year: 2013
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
Angular deformities of the lower limbs are a common clinical problem encountered in pediatric orthopaedic practices particularly in patients with osteochondrodysplasias. The varus deformity is more common than the valgus deformity in achondroplasia and hypochondroplasia patients because of the unusual growth of the fibulae than that of the tibiae. We retrospectively reviewed six patients (four patients with achondroplasia and two patients with hypochondroplsia) with relevant limb deformities due to the above-mentioned entities. All patients manifested significant varus deformity of the lower limbs. Detailed phenotypic characterization, radiologic and genetic testing was carried out as baseline diagnostic tool. We described the re-alignment procedures, which have been applied accordingly. Therefore, bilateral multi-level procedures, multi-apical planning and limb lengthening have been successfully applied. While recognition of the underlying syndromic association in patients who are manifesting angular deformities is the baseline for proper orthopaedic management, this paper demonstrates how to evaluate and treat these complex patients.