PURPOSE: This paper examined the results of a tibiofibular osteotomy and external fixation in idiopathic genu varum. MATERIALS AND METHODS: Ten patients (20 cases) with idiopathic genu varum were treated with a tibiofibular osteotomy and external fixation. The average follow-up period was 13 months (range, 6-27). The average age of the patients was 23.1 (range, 16-39). A tibial osteotomy was performed an average 9.1 cm (range, 5-13.5) distal to the tibial spine, which was 2 cm distal to the center of the rotation axis (CORA). RESULTS: The preoperative anatomical tibio-femoral angle of varus, 7.0o (range, 4-10), was corrected to valgus 0.8o (range, varus 5-valgus 6). After surgery, the femur intercondylar distance of 5.3 cm (range, 4-7) was improved to 0.4 cm (range, 0.5-4), and the preoperative average maximal intercalf distance of 11.2 cm (range, 8.5-13) was improved to 6.5 cm (range, 4-9). A preoperative mechanical axis deviation of 2.0 cm (range, 0-3.5) improved to 0.3 cm (range, 0-2.3). The complications encountered were 4 cases of a pin site infection, 1 case of a superficial peroneal sensory nerve injury, 1 case of a deep peroneal nerve partial injury and 2 cases of a popliteal artery partial occlusion. CONCLUSION: The tibiofibular osteotomy and external fixation is considered to be an effective method for treating an idiopathic genu varum with early ROM and weight bearing. However, surgeons need to pay careful attention in order to prevent a neurovascular complications.
Axis, Cervical Vertebra ; Femur ; Follow-Up Studies ; Genu Varum* ; Humans ; Osteotomy* ; Peroneal Nerve ; Popliteal Artery ; Spine ; Weight-Bearing

BACKBROUND AND PURPOSE: The flow diverting effect of a low-wall coverage stent remains controversial. We evaluted patients who underwent stenting for small aneurysms with a low but potential risk of growth and reviewed related literature. MATERIALS AND METHODS: We evaluated 9 small aneurysms among 19 unruptured intracranial aneurysms from eight patients who underwent stenting. The patients had unexplainable severe headache (n = 8), aneurysm originating from the anterior choroidal artery (n = 3), potential growth or rupture risks including hypertension (n = 5), and multiple aneurysms (n = 6). Stents with a relatively low-wall coverage ratio (8-10%) were used. Clinical and angiographic outcomes were assessed. RESULTS: One (n = 8) or two stents (n = 1) were used without any procedural difficulties or complications. Although no immediate changes of aneurysm morphology were observed, aneurysms decreased in size (n = 8) when examined by DSA (n = 8) or MRA (n = 1) during a median 28.9-month follow-up. There were no adverse events, including thromboembolism, aneurysm rupture, or stent movement during a median 31.9-month clinical follow-up (range: 17-69 months). CONCLUSION: Although a variable degree of aneurysm size decrease may not prevent further growth or rupture of small aneurysms, stenting with a low-wall coverage ratio may have some advantageous hemodynamic effect. Flow modification of stent architecture vs. aneurysm characteristics, including size and location, on long-term outcome, requires further clarification.
Aneurysm* ; Arteries ; Choroid ; Follow-Up Studies ; Headache ; Hemodynamics ; Humans ; Hypertension ; Intracranial Aneurysm ; Rupture ; Stents* ; Thromboembolism