Decortication and osteotomy for the correction of multiplanar deformity in the treatment of malunion in adult diaphyseal femoral deformity: a case series and technique description

Aim: To review patients that have undergone correction of a symptomatic femoral malunion using osteotomy combined with decortication. Methods: A retrospective review of all patients who have undergone decortication and multiplanar osteotomy, looking at the pre-operative deformity, correction achieved, time to union and complications. Results: Seven patients underwent correction under the senior author from 2003 to 2012. Average age was 46 years (range 32–60 years). All had femoral shortening deformity (average 2.7 cm, range 2–4 cm). Each also had at least one other plane of deformity with rotation being the next most commonly encountered in 5 out of the 7 (average 33°, range 0°–45°). Two had tri-planar deformity with the five having bi-planar deformity. Average time to union was 16.3 months (range 7–39 months) with an average of 1.5 operations (range 1–3 operations) to union. One patient has a non-union after five corrective operations. Conclusion: Correction of multiplanar deformity of the femur is challenging. Osteotomy with decortication provides a technique to achieve significant femoral multiplanar deformity correction in a single operation. This publication provides technical description of the operative technique, guidance and results. © 2017, Springer-Verlag France SAS.