Abstract
Diaphyseal malunion poses a great challenge for the orthopedic surgeon, and an inundation of morbidity for the patient. Diaphyseal malunion can cause altered gait, adjacent joint osteoarthritis and body dissatisfaction. This problem is fraught with complications without surgical intervention. There is a myriad of options for the management of a diaphyseal malunion. The clamshell osteotomy was engendered to ameliorate the difficulty in managing this issue. This technique is a viable option to correct diaphyseal malunion about the femur and tibia. Recently, the indications of a clamshell osteotomy have been expanded to function as a derotational or shortening osteotomy.
Highlights
Diaphyseal malunion is a complex issue for the orthopedic surgeon
Diaphyseal malunion leads to increased joint reactive forces predisposing to osteoarthritis, altered gait kinematics, and an undesirable cosmetic appearance [1]
There is an additional layer of complexity with orthopedic management of long bone fractures associated with diaphyseal malunion [2]
Summary
Diaphyseal malunion is a complex issue for the orthopedic surgeon. Diaphyseal malunion leads to increased joint reactive forces predisposing to osteoarthritis, altered gait kinematics, and an undesirable cosmetic appearance [1]. There is an additional layer of complexity with orthopedic management of long bone fractures associated with diaphyseal malunion [2]. The clamshell osteotomy was created for managing diaphyseal malunion [3,4] This technique allows for bypassing of the diaphyseal malunion using the intramedullary nail to restore the coronal and sagittal plane anatomical axes of the long bone and stabilizes a concomitant fracture if present [2]. This osteotomy consists of three cuts including a single longitudinal and two transverse bone cuts. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
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