Double Oblique Osteotomy: A Technique for Correction of Posttraumatic Deformities of the Distal Femur

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Abstract

Objective:

To evaluate the outcomes of a double oblique osteotomy for the management of distal femoral malunions and a combination malunion/nonunion.

Design:

Case series.

Setting:

Level 1/2 hospital.

Patients/Participants:

Ten patients with a mean age of 50 years (range 30–69 years) with posttraumatic deformities of the distal femur.

Intervention:

A 2-level, length-sparing osteotomy was performed in accordance with a detailed preoperative plan for correction of the mechanical axis in a distal femoral deformity.

Main Outcome Measurements:

Radiographic alignment and physical examination.

Results:

Average length of follow-up was 26 months. The average coronal plane correction was 12 degrees (range 4–20 degrees) for a residual coronal plane deformity average of 0 degrees. The residual flexion deformity was less than 10 degrees in all cases. All rotational deformities were corrected to within 5 degrees of neutral. The average limb length correction was 1.6 cm (range 0.4–2.6 cm). Eight patients recovered without complication. One patient received bone grafting to achieve union, and a prominent angled blade plate was removed in another. An isolated saphenous nerve sensory deficit resolved spontaneously.

Conclusions:

The double oblique osteotomy is a reliable technique for the correction of multiplane deformities of the distal femur.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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