35 yr old engineer developed a malunion of an upper tibial fracture with shortening of 2 cm and varus deformty after the nail broke.The nail broke about 1 cm above the site of the maximum deformity. Hence it would have been very destructive and damaging to remvoe the nail.The task was to straighten the bone and lengthen it and we chose to do it without removing the nail.
The xray during treatment shows how the rule 3 of deformity correction has been applied here in the lengthening mode. Here the osteotomy as well as the hinges were placed away from site of maximum deformity and hence resulted in correction of varus with a lateral translation which was desirable.
xray shows full correction of the deformity along with the scanogram showing equal leg lengths.
His limbs are straight an completely equal now.
Bibliography & References:
1) Treatment of Malunions & MalNonunions of the Femur & Tibia by detailed
pre- op planning & Ilizarov Techniques
Paley, D., Chaudhary, M., Pirone, A.M., Lentz,P., Kautz, D.
Orthop. Clin. North Am. 21: 667, 1990
2) TransOsseous Osteosynthesis: Theoretical & Practical aspects of growth
& regeneration of Tissues
Springer Verlag, Berlin 1992
3) Principles of Deformity Correction
Springer Verlag, New York, 2002