#surgicalpearls
measure axis femoral head to ankle
correct to medial tibial spine
measure angle of correction/wedge needed
confirm w/alignment rod
do #Mosaicplasty #cartilagerestoration first
2 breakable parallel oblique (proximal to distal) pins distal femur
+/- 2 additional pins proximal and distal segment to measure rotation correction
Oscillating saw cortex, anterior + posterior (protect w/ Hohman)
Care not to breach medial cortex - leave 1 cm
Use variable size osteotomes
Leave wedges in then apply matching plate w/ spacer
External rotate distal segment to get trochlea underneath the patella i.e. correct excessive #femoralanteversion (internal rotation of femur)
Apply locking plate
+/- wedge allograft or iliac crest autograft or bone chips