Treatment of genu recurvatum with the Ilizarov external fixator and proximal tibial corticotomy

Jahng, Jun Seop; Hahn, Soo Bong; Park, Hui Wan; Kim, Bum Soo

Abstract

Genu recurvatum deformity of the knee can be due to the deformity of the bone of the proximal end of the tibia or to the changes in the soft tissues, or both. The causes of acquired genu recurvatum include trauma, wire traction of the tibia, operative procedures involving the proximal tibial physis, Osgood-Schlatter's disease, osteomyelitis and prolonged immobilization. The most frequent symptoms of genu recurvatum are weakness, pain and instability of the knee, genu valgus, and shortening of the affected lower extremity. Operative treatment consists of tibial osteotomy and soft tissue procedures performed on the capsule and ligaments, and recently percutaneous corticotomy of the proximal tibia and gradual correction by the Ilizarov external fixator became one of the treatment modalities. From Nov. 1990 to June 1993, the authors have performed gradual correction by the Ilizarov external fixator in 6 patients of genu recurvatum and the results were as follows. 1. The mean age was 14 years ranging from 11 to 21. And there were 2 males and 4 females. 2. In the past history, there were ipsilateral femur fractures in 5 cases in which 4 cases were treated with skeletal pin traction on the proximal tibia, and one case had ipsilateral open tibiofibular fracture. 3. After Ilizarov external fixation, proximal tibial corticotomy just inferior to the tibial tuberosity were performed in all 6 cases. 4. The follow up period was 19 months in average. 5. The results were evaluated according to a scoring system that was suggested by Lecuire et al.: 2 cases were excellent, 3 cases were good and 1 case was fair. 6. Ilizarov gradual correction was very effective not only in the treatment of genu recurvatum but also in the concurrent correction of limb length inequality and mechanical axis deviation of the lower extermity.