A precision guide-pin technique for wedge and rotatory osteotomy of the femur and tibia

Intraoperative guide-pin placement for the performance of wedge-type and rotatory osteotomy of the femur and tibia provides the desired angle of correction from single-leg, weight-bearing roentgenograms. A template is used as a guide for pin placement. The accuracy of this technique was evaluated by comparing the preoperative goal with the correction achieved immediately after surgery and after bone healing one year postoperatively. Forty-seven osteotomies, 37 in the tibia and ten in the femur, were reviewed. Eighty-five percent of the cases were within +/- 3 degrees of the operative goal immediately after surgery, and 81% one year postoperatively. Four osteotomies (9%) were considered failures, two because of technique and two because of errors in postoperative patient activity level. With appropriate preoperative planning, the technique makes accurate osteotomy possible in a standard operating room equipped with a C-arm fluoroscope.