Open AccessTreatment of a Diaphyseal Tibial Malunion with Use of the Clamshell Osteotomy
Author(s) -
Robinson Esteves Santos Pires,
Igor Guedes Nogueira Reis,
Egídio Oliveira Santana
Publication year - 2021
Publication title -
jbjs essential surgical techniques
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 7
ISSN - 2160-2204
DOI - 10.2106/jbjs.st.20.00059
Subject(s) - malunion , nonunion , medicine , osteotomy , deformity , intramedullary rod , surgery , fixation (population genetics) , orthodontics , external fixation , population , external fixator , environmental health
Malunion, nonunion, congenital abnormalities, and osteometabolic diseases are the main causes of long bone deformities 1 . Although the exact incidence is unclear, it is estimated that about 10% of all fractures have some complication in terms of fracture-healing. In addition to the aesthetic impact, malunions generally substantially impair function and quality of life 1 . Every malunion is unique, and treatment is usually planned according to the degree of deformity and the postoperative expectations of the patient 2 . However, it is noteworthy that deformity correction usually requires a high degree of surgical expertise. Several techniques have been proposed over the years, and new techniques that utilize current technologies are available, such as computer-assisted single-cut osteotomy 3 . In 2009, Russell et al. proposed the clamshell technique for diaphyseal malunions 4-6 . This technique is our preferred treatment for diaphyseal malunions and acute fractures in the setting of a previous malunion or deformity. The following videos will thoroughly describe the steps to perform this useful and effective surgical technique for malunion correction.