A new methodology for the planning of single-cut corrective osteotomies of mal-aligned long bones

Abstract

Background. Corrections of combined torsional and angular deformities of long bones may be performed creating a single osteotomy which is oriented so that rotating the two fragments on the created osteotomy plane allows to correct all deformities in one step. A practical geometrical tool is presented to facilitate the difficult preoperative planning of such osteotomies. Methods. The geometrical tool consists of two limbs connected by a mobile disk representing the osteotomy plane. This allows the two limbs to be deliberately bent and rotated against each other. Thereby, the mobile disk will change orientation in such a way that it will indicate the osteotomy plane needed in order to anatomically align the two limbs. The geometrical principle of the tool has been confirmed mathematically and compared with data from the literature. Five deformed test bones have been used to test the effectiveness of the tool. Findings. The geometrical principle of the tool is equivalent with the mathematical data from the literature. The maximal osteotomy angle which can be indicated by the tool is 65°, with an error of ±3° compared to mathematically calculated values. The five test bones were all aligned anatomically with appropriate accuracy. Interpretation. The presented tool can be easily used and facilitates largely the preoperative planning of a single cut osteotomy for complex deformities of long bones. It allows to avoid sophisticated mathematical calculations and helps to avoid the risk for errors in planning and performing correctional osteotomies.