OPENING-WEDGE OSTEOTOMY FOR ANGULAR DEFORMITIES OF LONG BONES IN CHILDREN

Mild angular deformities associated with a mild limb-length discrepanc y of long bones in children can be treated effectively with opening-we dge osteotomy with insertion of a specially prepared autogenous tricor tical iliac-crest bone graft and with minimum or no internal fixation. Thirty-one osteotomies in twenty-six children satisfactorily correcte d the deformities so that the angulation and length of the bone were c omparable with the values on the normal, contralateral side. Physeal a rrest or ipsilateral excision of a physeal bar was performed either co ncomitantly or at a separate operation in twenty-one of the twenty-six patients, to aid in the treatment of the limb-length discrepancy. Ope ning-wedge osteotomy is applicable for correction when the angular def ormity is 25 degrees or less and the limb-length discrepancy is, or wi ll be, twenty-rive millimeters or less at maturity.