Boekesteijn Ramon J, Smulders Katrijn, van Gelder Janke H, Keijsers Noël L W, Bisseling Pepijn
Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands.
Department of Orthopedic Surgery, Sint Maartenskliniek, P.O. box 9011, Nijmegen, 6500 GM, The Netherlands.
BMC Musculoskelet Disord. 2025 Jul 4;26(1):634. doi: 10.1186/s12891-025-08800-y.
Derotational osteotomy aims to alleviate pain and enhance physical functioning in adolescents with a rotational deformity of the lower extremities, but remains a topic of controversy. Therefore, this study aimed to evaluate the impact of derotational osteotomy on walking capacity, pain, and physical function in individuals with a rotational deformity of the lower extremity.
Eighteen adolescents ( = 27 limbs) who underwent unilateral or bilateral derotational osteotomy of the femur and/or tibia were included in this study. The 6-minute walk test (6MWT), lower extremity functional scale (LEFS), pain over the last 24 h and the last week (numeric rating scale, (NRS)), and gait kinematics obtained during 3D gait analysis were all assessed preoperatively and 1 year after (the last) surgery. Treatment satisfaction was obtained using a visual analog scale (VAS).
6MWT distance increased by 34 m [95% CI: 9, 59] after derotational osteotomy. In addition, adolescents experienced less pain over the last 24 h (mean difference = -3.1 points [95% CI: -4.5, -1.6]) and the last week (mean difference = -2.3 points [95% CI: -4.0, -0.7]). The LEFS score improved with 14 points [95% CI: 8, 20] after derotational osteotomy. Gait kinematics showed a more neutral hip rotation and foot progression angle during the stance phase. Treatment satisfaction was high, with postoperative VAS scores of 8.5 (6.1 to 10.0).
Overall, walking capacity, pain, and self-reported physical function improved after derotational osteotomy, leading to high satisfaction rates. However, because factors such as the laterality of surgery (i.e. unilateral vs. bilateral), the involved bones (i.e. femur and/or tibia), and direction of rotation (i.e. internal vs. external rotation) may differently influence treatment outcome, further research is warranted to better understand how these factors affect outcome after derotational osteotomy.
The online version contains supplementary material available at 10.1186/s12891-025-08800-y.
去旋转截骨术旨在减轻下肢旋转畸形青少年的疼痛并改善身体功能，但仍是一个有争议的话题。因此，本研究旨在评估去旋转截骨术对下肢旋转畸形患者步行能力、疼痛和身体功能的影响。
本研究纳入了18名接受单侧或双侧股骨和/或胫骨去旋转截骨术的青少年（共27条肢体）。术前及术后1年（最后一次手术）均评估6分钟步行试验（6MWT）、下肢功能量表（LEFS）、过去24小时和过去一周的疼痛情况（数字评分量表，NRS）以及三维步态分析过程中获得的步态运动学参数。使用视觉模拟量表（VAS）获得治疗满意度。
去旋转截骨术后6MWT距离增加了34米[95%置信区间：9，59]。此外，青少年在过去24小时（平均差异=-3.1分[95%置信区间：-4.5，-1.6]）和过去一周（平均差异=-2.3分[95%置信区间：-4.0，-0.7]）的疼痛减轻。去旋转截骨术后LEFS评分提高了14分[95%置信区间：8，20]。步态运动学显示在站立期髋关节旋转和足前进角更趋于中立。治疗满意度较高，术后VAS评分为8.5（6.1至10.0）。
总体而言，去旋转截骨术后步行能力、疼痛和自我报告的身体功能均有所改善，导致满意度较高。然而，由于手术的侧别（即单侧与双侧）、受累骨骼（即股骨和/或胫骨）以及旋转方向（即内旋与外旋）等因素可能对治疗结果产生不同影响，因此有必要进行进一步研究，以更好地了解这些因素如何影响去旋转截骨术后的结果。
在线版本包含可在10.1186/s12891-025-08800-y获取的补充材料。
