Topics
BONE TRANSPORT
bone defects
NONUNION - MALUNION MENAGEMENT
LİMB LENGTHENING
LIMB LENGTHENING
Fixation Methods
The selection of an appropriate bone fixation method is a critical step in lower-limb deformity correction that must be preceded by a thorough geometric analysis of the skeletal abnormality. Surgeons typically choose between internal fixation, such as plates or intramedullary nails, and external fixation systems, with the choice primarily dictated by whether the correction is to be performed acutely or gradually. Adherence to established planning principles and the correct application of the chosen hardware are essential to ensure successful collinear realignment and prevent the occurrence of secondary deformities.
Principles of Osteotomy
Osteotomy is the surgical cutting or division of bone, and its therapeutic use dates back to Hippocrates. It began to be used in bone lengthening surgery with Ilizarov`s description of distraction osteogenesis. Low-energy osteotomies are preferred in bone lengthening surgery; they promote bone healing by preserving periosteal and endosteal circulation.
Distal Tibial Osteotomy (DTO) / Supramalleolar Osteotomy (SMO)
High Tibial Osteotomy (HTO)
Distal Femoral Osteotomies (DFO)
Distal femoral osteotomy (DFO) is a joint preservation procedure that corrects genu valgum deformities and patellofemoral maltracking, thereby restoring kinematics and unloading contact pressures in the lateral tibiofemoral and patellofemoral compartments.
Proximal Femoral Osteotomies
Deformity Evaluation and Analysis
Lower limb defomity evaluation and radiological analysis
Infection in Reconstruction Surgery
Forearm Malunion & Corrective Osteotomy
Surgical procedures to correct a fracture that has healed in an abnormal position (angular, rotational, translational, or shortened). Involves re-fracturing at or near the malunion site, correcting the deformity, and stabilizing with rigid fixation. Goal: Restore the mechanically coupled unit of the radius and ulna. Improve forearm rotation, alignment, and DRUJ stability.
Radial & Ulnar Lengthening / Shortening
Surgical procedures to restore forearm length balance by: Lengthening (distraction osteogenesis or acute grafting), Shortening (osteotomy and compression), Goal: Re-establish radioulnar relationship. 0 to slightly negative ulnar variance after shortening, and restoration of symmetry after lengthening,. Improve function, alignment, and stability,
Growth Modulation & Guided Growth
Growth modulation refers to controlled alteration of physeal growth to gradually correct deformity in skeletally immature patients. Guided growth is the most common clinical application, using temporary hemiepiphysiodesis to harness remaining growth for angular correction.
Humeral Osteotomies
Surgical realignment procedures of the humerus to correct: Deformity Malalignment Functional impairment Can be performed at: Proximal humerus Diaphysis Distal humerus
Elbow Deformity Correction
Surgical or non-surgical management of angular, rotational, or combined deformities around the elbow Most commonly involves: Distal humerus deformities (supracondylar malunion)