Correcting 'bendy legs' - deformity correction

On of the earliest aims of orthopaedic surgery is to correct deformities of the upper and lower limbs. In earlier days, these deformities were the result of polio. In modern times, these are generally due to malalignment, and rarely, the residual effects of an old injury. There are two broad techniques of correcting deformities -

1. Immediate correction at the time of operation and stabilisation using a plate or rod. This technique is used where the deformity is relatively minor or moderate and is correctable at the time of the operation.

2. Gradual correction over a period of days / weeks / months.  This is indicated where the deformity is too large to correct in one operation, or bone lengthening is needed. The bone, over this period, is stabilised using an external fixator (similar to a scaffold over the leg).

I use the first technique for individuals who develop knee pain as a result of inward / outward angulation of the leg. Around the knee, these surgeries are called -

a. High Tibial Osteotomy (HTO)

• Pre operative radiograph showing narrowing of the medial joint space Pre operative radiograph showing narrowing of the medial joint space
• Post operative radiograph showing the high tibial Post operative radiograph showing the high tibial
• Anterior slope of tibia after trauma Anterior slope of tibia after trauma
• Correction using a open wedge osteotomy Correction using a open wedge osteotomy
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b. Distal Femoral Ostetomy (DFO)

• posttraumatic arthritis of the lateral compartment of the knee posttraumatic arthritis of the lateral compartment of the knee
• correction of deformity with a opening wedge distal femoral osteotomy correction of deformity with a opening wedge distal femoral osteotomy
• long leg alignment view showing correction long leg alignment view showing correction
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c. Gradual deformity correction and leg lengthening

• deformity of distal tibia and shortening. Total knee replacement prosthesis in situ deformity of distal tibia and shortening. Total knee replacement prosthesis in situ
• correction of the deformity and lengthening of the tibia using a Taylor Spatial frame correction of the deformity and lengthening of the tibia using a Taylor Spatial frame
• correction of the deformity and lengthening of the tibia using a Taylor Spatial frame correction of the deformity and lengthening of the tibia using a Taylor Spatial frame
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The second technique is more complex and is needed for more complex deformities. It involves application of the external fixator, which has to stay on the leg for a period of time. However, the results achieved with the technique are remarkable and not achievable by other methods.

It is even possible to lengthen a bone using a frame.

If you have further questions, please contact us and I will be delighted to respond to any comments, questions or concerns.