PMC6942781_01
At the time of the initial visit to our department, visible valgus deformity of the right knee is noted.
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A physical examination revealed that the valgus deformity of the right knee was visibly obvious (Figure 1).
Simple X-ray images taken during the initial visit to our department. Severe valgus deformity is noted with an FTA of 160 degrees and a %MA of 100% from the medial edge of the tibial plateau.
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X-ray images at the time of the initial visit to our department showed severe valgus deformity with a femoro-tibial angle (FTA) of 160 degrees and % mechanical axis (%MA) of 100% from the medial edge of the tibial plateau (Figure 2).
Simple X-ray images at the time of injury (age 15). There are no obvious fractures or growth plate fractures.
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X-ray images taken at the time of injury (at age 15) showed no obvious fractures or growth plate fractures (Figure 3).
Simple MRI (T2-enhanced) at the time of injury. Mild bone marrow edema in the lateral condyle of the femur and a high signal area suggestive of hemorrhage under the muscular layer are noted.
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MRI at the time of injury (T2-enhanced) showed mild bone marrow edema in the lateral condyle of the femur and a high signal area suggestive of hemorrhage under the muscular layer (Figure 4).
X-ray images taken during the four years after the injury showed that the valgus deformity was gradually progressing each year.
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X-ray images taken during the four years after the injury showed that the valgus deformity was gradually progressing each year (Figure 5).
A bony bridge on the lateral side of the growth plate was noted on MRI taken at age of 16.
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A bony bridge on the lateral side of the growth plate was noted on MRI taken at the age of 16 (Figure 6).
Preoperative planning. mLDFA was planned to improve to 87 degrees and FTA to 178 degrees with a correction of 16 degrees.
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In preoperative planning, we planned to improve the mLDFA to 87 degrees and FTA to 178 degrees with a 16-degree correction (10 mm closing wedge) (Figure 7).
X-ray images and appearance of the lower limb six months after surgery. Bone fusion is achieved and %MA is 48.5% from the medial edge of the tibial plateau. Valgus deformity has improved in appearance.
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Valgus deformity has improved in appearance, whereas lower limb length discrepancy (SMD) improved to -0.5 cm in the left lower limb and the range of motion of the right knee also improved to 0 (extension) to 150 (flexion) degrees (Figure 8).