Severe varus deformities of the knee lead to abnormal gait and progressive joint degeneration. In complex cases, gradual correction using external fixation is often safer than acute correction with internal fixation. We report a 25-year-old male with a 30° varus deformity of the right knee treated with high tibial osteotomy and a monoaxial dynamic external fixator. A corticotomy was performed just distal to the tibial tubercle to preserve patellofemoral joint function. Gradual correction was carried out at a rate of 1 mm per day over 1.5 months, followed by maintenance of the fixator for an additional 1.5 months to allow bone consolidation. The tibiofemoral angle improved from 30° to 6°, and the mechanical proximal tibial angle improved from 57° to 82°. Satisfactory limb alignment was achieved without compromising patellofemoral mechanics or requiring fibular osteotomy, with no neurovascular or soft tissue complications. Monoaxial dynamic external fixation provides a controlled, effective, and safe method for correcting severe varus knee deformities, particularly in complex clinical scenarios.
Gudigar et al. (Thu,) studied this question.