Summary. The results of 247 osteotomies at the knee were analysed in 195 patients with Kashin-Beck disease. Since 1983, 37 varus and 210 valgus deformities have been operated on. Supracondylar osteotomy was carried out so that there is a cortical spike in the distal metaphysis which is impacted into the femoral condyle. A U-shaped tibial osteotomy is made 0.5 cm below the growth plate and around the insertion of the patellar ligament. The mechanical axis is corrected and stability obtained by impacting the fragments; internal fixation is not used. Correction of the initial angular deformities was achieved after the osteotomies, and function was improved.
Rsum. Les rsultats de 247 ostotomies du genou sont analyss sur 195 patients atteints de la maladie de Kashin-Beck. La technique dostotomie utilise se caractrise, au niveau de la mtaphyse distale du fmur, par la ralisation dune section supracondylienne prsentant un ergot cortical et au niveau de la mtaphyse proximale du tibia par une section respectant linsertion du ligament rotulien en la contournant distalement. Vu labsence de matriel de fixation interne ou externe, limpaction des fragments permet de stabiliser efficacement la correction de laxe mcanique. Depuis 1983, 37 genu vara et 210 genu valga ont t ostotomiss. Les rsultats prsentent la distribution des dformations angulaires initiales et les corrections obtenues aprs ostotomie. Lamlioration fonctionelle confirme lintrt de cette technique en labsence de matriel dostosynthse.