Abstract
Introduction
Corrective femoral osteotomy in adults, as a closed procedure with the use of an intramedullary saw, is an elegant, minimally invasive technique for the correction of lower limb length inequalities or problems of torsion. Stabilisation following the osteotomy was achieved with a cephalo-medullary nail. We report the indications, results and complications following use of this technique.
Aim
The aim of the study was to review consecutive patients who underwent closed femoral rotational or shortening osteotomy using an intramedullary saw over a ten-year period.
Material & Methods
Forty femoral rotational and/or shortening osteotomies using an intramedullary saw were performed on thirty-six patients, between January 2001 and June 2011. The main indications were post-traumatic leg length discrepancies and congenital rotational abnormalities. Clinical & radiological follow up mean was 16.3 months
Results
Twenty one osteotomies were performed for femoral shortening with the mean correction of 3.5 cm. Nineteen osteotomies were performed for correction of torsion; there was a mean correction of 28.64 degrees with Internal rotation and 35 degrees with external rotation osteotomies. Fourteen patients required removal of locking screws. There were two patients with heterotrophic ossification, two patients with wound infection (one deep infection). One patient had a materiovigilance incidence and one patient had vascular complication requiring embolisation. The subjective results showed 37 osteotomies were satisfied with their operation, functional recovery and aesthetic appearance of the scars.
Conclusion
Closed osteotomy of femur for correction of LLD and torsion using an intramedullary saw represents a reliable and effective procedure. Despite the complications, the original goal of the surgery was achieved in 37 of the 40 limbs treated. Patient satisfaction was achieved in 92.5 % of 40 osteotomies.
