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This limits the longitudinal growth and slows the process of angular correction.
Several techniques of epiphysiodesis have evolved, enabling gradual correction of angular correction and/or length equalisation through guided growth.
There was a correlation between the degree of angular correction and the time to healing of the osteotomy gap (Fig. 2).
Whilst the need for obligatory translation in an osteotomy away from the CORA has been appreciated, the amount required for a size of angular correction plus distance from the CORA has yet to be calculated.
Contralateral normal wrist radiographs were also obtained to aid in pre-operative planning and to ascertain the degree of angular correction needed at the osteotomy site in both sagittal (volar/dorsal tilt) and coronal (radial inclination) planes.
While osteotomy is necessary for rotational correction and limb lengthening, angular correction may be achieved by other means: several techniques of epiphysiodesis have evolved, enabling gradual correction of angular correction and/or length equalisation through guided growth.
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Open image in new window Fig. 7 Chart demonstrating the predicted translational deformity for opening-wedge osteotomy for a range of angular corrections and distances from the CORA.
The next logical step in this process would be to compare the translation predicted by our model with the actual translation produced across a range of angular corrections "in vivo".
The introduction of an angular correction in the model of Wang et al. which relates variations in the maximum load to the presence of residual stresses is proposed.
In this way, the anticipated translation would be 2 tan α × d), where α represents 50%% of the desired angular correction, and d is the distance of the desired osteotomy site from the CORA (Figs. 1, 2).
A predictive algorithm was derived where translational deformity was predicted as 2 tan α × d), where α represents 50%% of the desired angular correction, and d is the distance of the desired osteotomy site from the CORA.
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