Comprehensive Evaluation of Clinical and Radiographic Outcomes in The Correction of Complex Knee Deformities Using The Ilizarov External Fixator: A Multi-Parameter Outcome Study

Background: The natural history of lower limb alignment changes from varus to valgus during development. Therefore, complex knee deformities need adequate clinical examination and radiological assessment to exclude physiological from pathological causes. Management varies from conservative methods to surgical intervention, which include growth modulation or corrective osteotomies. Objective: This study aimed to assess functional and radiological outcomes of using distraction histogenesis in managing complex lower limb deformities around the knee.
Patients and methods: A prospective study held between February 2023 and January 2025, presented with coronal plane deviation among associated other plane deformities. Management was done using gradual distraction histogenesis using ilizarov external fixator. Patients were evaluated post-operatively using satisfaction criteria of achieving a mechanical axis through the center of the knee or within Zone 1 as well as the malalignment test.
Results: Our study showed satisfactory results in achieving the previously described correction goals in all cases except for two cases (94.4%) that had residual deformity post-frame removal.
Conclusion: Gradual correction using distraction histogenesis is a safe, accurate tool for achieving precise deformity correction and limb length equalization with the advantage of early weight-bearing, and shorter hospital stays.