Deformities can occur after a trauma with or without fracture, during growth or thereafter. They can also be at birth, congenital, or hereditary.
In children, the deformity should be evaluated, but also its evolution risk during residual growth. A small deformity can enlarge over time, and reversely.
Deformities can be observed in the three planes of the space:
The frontal (or coronal) plane refers to the front half of the body. Bone and joint deformities that occur in the front plane include :
Pictures : Genu Valgum (left), Genu Varum (right)
The transverse plane is defined as that occurring horizontally across the body. In this plane, the following deformities can occur:
- External/internal rotation. This rotation involves two different anatomical elements; for example, two different bones, such as the femora, can turn with respect to the pelvis in an internal or external rotation.
- Torsion. Torsion is a rotatory motion within a single bone between its two extremities. For example, excessive femoral torsion means that the torsion or rotation between the upper and the lower extremities of the femur is greater than the normal range.
The sagittal plane separates the left and right sides of the body from top to bottom and from front to back. Deformities in the sagittal plane include:
Lesions can be positioned as follows:
Lesions can also combine deformities at different levels.
COMBINATION OF SEVERAL BONE DEFORMITIES
Bone deformities can be combined within the same bone, or among a few bones. Bone and joint deformities can also be combined. Soft tissues are often involved.
According to the lesions, a custom-made program can be proposed, addressing bone, joint and soft-tissue lesions.
All deformities can be analyzed in 3 planes of space at each level of deformity. Corrections should, if possible, be performed at the level of the deformity and should be clearly planned to allow for a full correction.
Pictures from left to right:
1) 20° genu recurvatum (knee recurvatum); 2) In standing front position, it may mimic a genu varum (knee varus); 3)When the recurvatum is corrected with knee extension at 0°, the genu varum corrects by itself: it is so far a false genu varum which does not need correction in itself; 4) On X-rays, the origin of the genu varum is observed: proximal tibial recurvatum of 10° (angle B at 90° instead of 80°), and a 10° joint recurvatum (laxity in the joint). A tibial bony correction will correct in a great par the deformity.