Deformities to limbs can cause the alignment to deviate from its normal axes
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THE HEALTH | AUGUST , 2023
| Column |
BONE TO PICK
Setting things straight
Deformities to limbs can cause the alignment to deviate from its normal axes
THERE COMES a time in a person ’ s life when they have to pause and re-evaluate matters and , when necessary , set things straight .
When certain aspects do not line up , no matter how small it may seem at first , it may set in motion a chain of reactions , eventually leading to more significant problems with more devastating effects .
“ Setting things straight ” is a metaphorical term used to fix , correct , or amend something . It doesn ’ t necessarily mean you are physically straightening something out . Well , not always , anyway .
Let us take the human body , for example . Our legs ( or the lower limbs as we call it scientifically ) should generally appear straight when looked at from the front .
Every so often , there may be deformities to our limbs that cause the alignment to deviate from its normal axes . So , what is a normal axis ? The fancy way to describe the alignment of the entire legs when looked at from the front is called the “ lower limb axis ”.
VALGUS DEFORMITY
Although this condition can be detected from the physical examination of a patient , it is more accurately calculated by performing X-ray radiographs of the entire lower limb .
It is a type of radiograph whereby the entire limb , from the pelvis to the feet , is shot in a single X-ray . From this special X-ray , your doctor can calculate some angles . They would identify the centre of the hip and the ankle on the X-rays and draw a straight line connecting them .
This line is called the mechanical axis and should run through somewhat the centre of the knee . There are many other lines , angles , and axes , but I won ’ t bore you with too many details .
When this line does not bisect the knee ’ s centre , one may have a valgus deformity ( knocked knee ) or a varus deformity ( bowed knee ). There could be many reasons why a patient could develop such a condition .
It could be congenital , developmental , due to trauma or , as we see pretty commonly , due to
Osteotomy of the tibia ( leg bone ), femur ( thigh bone ), or both may be required . In the same setting , any concomitant injuries involving the joint itself can be addressed arthroscopically . So , while the phrase “ setting things straight ” may be just metaphorical in most instances , it is used literally here . ”
arthritic degeneration of the knee joint .
As mentioned earlier , when things do not line up , it can sometimes result in other conditions . But before that , let us step back to see why this line is important .
One simplified explanation is that the forces passing through the knee should ideally be well distributed throughout the knee . When the line falls on either side of the knee instead , the impact will also go through that side more .
Dr Jonas Fernandez is an Orthopaedic Surgeon at Putrajaya Hospital . He is also a member of the Malaysian Arthroscopy Society ( MAS ).
TREATING THIS MALALIGNMENT
This will lead to excessive pressure on the affected side , which could lead to injuries to the structures in the knee joint , like the meniscus and the cartilage . Another role it plays is in stabilising the patella ( knee cap ), a condition I will describe more of in my next article .
So how can we treat this malalignment ?
Well , we set it back straight ! Your doctor may recommend performing an osteotomy ( a fancy way to say breaking the bone ), correcting its alignment to the desired amount and then holding it in place with a plate and some screws .
Osteotomy of the tibia ( leg bone ), femur ( thigh bone ), or both may be required . In the same setting , any concomitant injuries involving the joint itself can be addressed arthroscopically .
So , while the phrase “ setting things straight ” may be just metaphorical in most instances , it is used literally here .
When this line is no longer straight like what we want it to be , there can be interventions to set it straight and prevent any further possible insults to the limb . – The Health