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This defines the plane of osteotomy.
Open image in new window Fig. 4 Plane of osteotomy.
Translation along the plane of osteotomy allows correction of translational deformity with restoration of length.
The starting points for describing this plane of osteotomy are the plane of angular deformity and the bisector of the angular deformity.
We present a simple graphical method for determining this total plane of deformity and the plane of osteotomy about which the total deformity can be corrected.
Other methods of describing this plane of osteotomy reference from the plane of the proximal or distal segment as the starting point and require two re-orientations of the blade to find the plane of osteotomy with the second reorientation towards the direction of rotation by half the rotational deformity.
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We used a cylinder model to measure the unexpected angulation according to the direction of the cutting plane of the osteotomy site after closed-wedge osteotomy.
The upper plane of the osteotomy wedge had an angle of 15° to the horizontal plane.
Open image in new window Fig. 2 Photograph of a synthetic femur in antero-posterior and lateral plane, following osteotomy of femoral neck using the three-dimensional cutting guide (Embody, UK).
When the PASA has to be corrected, a second osteotomy proximal to the dorsal cut is performed, also orthogonal to the horizontal plane of the first metatarsal; this osteotomy is obviously performed to obtain a trapezoidal wedge with medial basis (Fig. 3).
This method may be applied to deformity correction in any bone where rotational and angular deformities are combined and considerably simplifies the planning of single-plane osteotomy for the correction of complex deformity.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com