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Unexpected angular or rotational deformity after corrective osteotomy.

Seung Yeol Lee, Jiwon Jeong, Kyungho Lee

  • 1Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Kyungki, Korea. jehee@mrl.snu.ac.kr.

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Orthopedic surgeons must understand geometry to prevent unexpected deformities during procedures like corrective osteotomy. This study highlights potential angular and rotational issues in shoulder and femur surgeries.

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Area of Science:

  • Orthopedic Surgery
  • Surgical Anatomy
  • Biomechanical Engineering

Background:

  • Codman's paradox illustrates geometric misunderstandings in orthopedic interventions.
  • Surgeons may encounter unexpected angular or rotational deformities during procedures like corrective osteotomy.
  • Understanding orientation and rotation is crucial in orthopedic surgery.

Purpose of the Study:

  • To alert orthopedic surgeons to the concepts of orientation and rotation.
  • To demonstrate the potential for unexpected deformity following orthopedic interventions.
  • To analyze deformities in shoulder arthrodesis, femoral varization derotational osteotomy, and femoral derotation osteotomy.

Main Methods:

  • A shoulder model was used to quantify rotational deformity.
  • A cylinder model simulated femoral varization derotational osteotomy.
  • A reconstructed femoral model assessed deformities during femoral derotation osteotomy.

Main Results:

  • Unexpected external rotation occurred in shoulder joint movements.
  • Femoral varization derotational osteotomy resulted in unexpected extension and valgus deformity.
  • Femoral derotation osteotomy led to varization and extension of the distal fragment.

Conclusions:

  • Surgeons must anticipate unexpected angular deformities in bone surgeries.
  • The extent of deformity varies with the specific orthopedic procedure.
  • Significant deformities are possible in procedures like femoral varization derotational osteotomy.