الفهرس Only 14 pages are availabe for public view
 |  | from | 150 |  |  |
| | | from | 150 | | |
Abstract
Complications (infection, compartment syndrome, neurologic problems, or nonunion) were little and improvement of function with relieve of anterior knee pain were the result of osteotomy.
Extensor mechanism realignment showed a high failure rate when the underlying cause of patellofemoral pain was excessive femoral anteversion, external tibial torsion, or both.
Femoral rotational osteotomies can be carried out proximally, in the midshaft, or distally. The intertrochanteric region of the femur is the preferred site for proximal osteotomies, and fixation by either large plate or interlocking nail.
The angle of the transmalleolar axis and the thigh-foot angle must be assessed to determine that the rotational problem is in the tibia and not in the foot. The more proximal tibial osteotomy when concurrent varus or vulgus knee deformity is preferred. Otherwise it is recommended for a supramalleolar osteotomy. Fixing the osteotomy by either crossing wire, pins or plates.
Fibular osteotomy is reserved for limbs where it is not easy to achieve desired rotation with intact fibula.
Patients complaining of anterior knee pain as a result of abnormal rotation either of the tibia, the femur or both should know the natural history of the disease and take their chance in conservative treatment avoiding the positions that increase the torsion and early operation is not indicated till teens when surgical correction is indicated after failure of conservative treatment.