ABSTRACT

The aim of this study is to investigate neurologic complications of closed wedge valgization osteotomy technique using electrophysiological methods.

Eleven extremities of 11 patients (mean age 52.75±5.39) with medial gonarthrosis and varus deformity were included. All patients underwent closed wedge valgization osteotomy in order to correct varus deformity.

The post-operative amplitude of nervus peroneus superficialis significantly decreased when compared to pre-operative amplitude. The mean pre-operative N. peroneus superficialis amplitude was 12.77, whereas it reduced to 5.44 postoperatively (p<0.05). Other nerve conduction velocity investigations showed no significant differences between pre- and post-operative values. A Needle Electromyography (EMG) study demonstrated neurogenic involvement in 4 patients after surgery. All of these 4 patients had denervation in the m.extensor hallucis longus needle EMG study. In 2 patients, the musculus tibialis anterior needle EMG study showed neurogenic involvement. One of these had denervation. One patient showed denervation in the m.extensor digitorum brevis needle EMG study.

Although fibula osteotomy used in the closed wedge osteotomy technique was applied from the safe zone, electrophysiological investigations suggested that this zone may, in fact, not be safe. (JAREM 2014; 1: 12-7)

Keywords: Closed wedge, high tibial osteotomy, valgization osteotomy, peroneal nevre