Abstract: Background: Aim of our study was to assess the functional outcome of Medial Open Wedge High Tibial Osteotomy performed in patients of varus mal-union after intra-articular fractures of proximal tibia.
Methods: This study included prospective analysis of 16 patients of varus mal-union of tibia after intra-articular fractures of proximal tibia treated at our institute between June 2011 to January 2018. All patients were operated under spinal anaesthesia. Patients were called every 2 weeks for follow up examination till 3 months, every month till 6 months, every 2 months till one year and yearly thereafter. Radiographs were taken at 6th and 12th week. Knee Society Scoring system was used to evaluate Functional Outcome.
Results: 16 patients diagnosed as varus mal-union of tibia presenting after minimum of 6 months after the treatment for intra-articular fractures of proximal tibia were included in the study. There were 14 male patients and 2 female patients, with the mean age of 47 years (range, 26–55 years). Mean duration of follow-up from the time of Medial Open Wedge High Tibial Osteotomy was 3.2 years. (Range 2 – 4.5 years). All patients achieved clinical and radiological union from 3.5 to 6 months with mean interval of 4.2 months. Medial Proximal Tibial Angle was corrected from mean 750 (range 700-850) to mean 870 (range 830-900) (P<.001). Functional scores improved from mean of 27% to 89% (P<.001) at final follow up examination. 13 patients (81.25%) had excellent outcome (KSS > 90), 2 (12.5%) had good outcome (KSS 75-90) and one patient (6.25%) had fair outcome (KSS 60-75).
Conclusions: Our study results demonstrates that Medial Open Wedge High Tibial Osteotomy is safe and effective procedure for varus mal-united proximal Tibial fractures in relatively young patient category.
