An accurate method of determining a single-plane osteotomy to correct a combined rotational and angular deformity

Abstract

Conventional osteotomy used for the correction of deformity is performed out of the plane of deformity creating a wedge either opening or closing when the deformity is corrected. Deformity that is a combination of rotation and angulation exists in a single plane that is oblique to the coronal, sagittal and axial planes depending on the magnitude of deformity measured in each plane. Accurate planning and a simple method of finding this oblique plane operatively is presented. This method starts by finding the bisector of angulation. This is marked by a wire that lies in the plane of angulation and along the bisector of angulation. The saw blade is rotated about this bisector axis according to the proportion of angulation and rotation. There is no second reorientation of the saw blade required making the final plane much easier to define. This single-plane oblique osteotomy allows accurate realignment of the limb.

Correction of Angular Limb Deformities in Two Dogs Using a Conformation-Based Surgical Approach and Planning Software

“…The true plane and magnitude of the deformity was derived and additionally imposed on the mesh model and bi-oblique sliding osteotomies were planned virtually. 18 All steps of the CBSP procedure and modeling were performed manually, with case 1 utilizing traditional mesh modeling. Alterations to the surgical 3D printed components required manual update of the entire model.…”

Three-dimensional analysis of posttraumatic tibial shaft malunion and correction based on the healthy, contralateral leg

“…1 ) oder Domeosteotomie. Bestehen eine Angulations- und Rotationsfehlstellung liegt die Korrekturebene schräg zur Tibiaachse [ 15 , 20 ]. Eine Rotation um eine Osteotomie in dieser Ebene (Single-cut-Osteotomie) korrigiert beide Deformitäten bei hoher Kontaktfläche.…”

Proximal Rotational Metatarsal Osteotomy for Treatment of Hallux Valgus: A Technique Guide

“…The correction of combined angular and rotational deformities with a single osteotomy has been most widely reported in tibial and femoral deformities. To determine the plane of the ideal osteotomy, several techniques exist which are well described21–23 but can be cumbersome and are beyond the scope of this article. When determining the orientation of the osteotomy plane, a simple miscalculation or misunderstanding could cause the surgeon to make an osteotomy that actually worsens the deformity rather than corrects it 23.…”

“…To determine the plane of the ideal osteotomy, several techniques exist which are well described21–23 but can be cumbersome and are beyond the scope of this article. When determining the orientation of the osteotomy plane, a simple miscalculation or misunderstanding could cause the surgeon to make an osteotomy that actually worsens the deformity rather than corrects it 23. Thus, some authors have described computer designed patient specific cutting jigs for complex deformity corrections 24.…”