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

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.