Osteotomies for deformity correction on the pediatric knee

Abstract

Fractures in childhood can result in malalignment and/or leg shortening due to insufficient reduction, malunion or injury to the growth plate. Different types of posttraumatic deformities around the knee as well as the diagnostic approach and correction are discussed. While deformities without shortening can often be corrected during surgery with internal fixation, limb shortening with or without malalignment has to be treated with external fixation or internal lengthening nails. Modern six-axis external fixators enable simultaneous lengthening and axial correction in all planes in patients from childhood onwards. Acorrection using lengthening nails is possible at the end of growth or if the physis has already been closed by trauma. Precise analysis of the deformity and leg length discrepancy is necessary to select the best point in time and the right surgical procedure and hardware for correction.