CLOSED DEROTATION OF THE FEMUR USING THE INTRAMEDULLARY SAW

Over the period 1986-1991, closed derotational osteotomy of 13 femora has been performed. Ten patients, two males and eight females (mean age 19.2 years; range 13-24) presented with a clumsy, in-toeing gait, pain or instability of the ankle, or with an unacceptable deformity. Before correction, pedobarography demonstrated high pressure over the hallux with medialization of the centre of pressure through the foot. Osteotomies were performed using the Biomet intramedullary cam saw, and intra-medullary nails were inserted after derotation. No post-operative complications were encountered. Quadriceps function returned within 2-8 days, and all osteotomies healed radiographically within three months. All deformities were corrected satisfactorily, and all patients were pleased with the outcome. Derotation of the femur restored a normal foot pressure distribution. We conclude that closed intra-medullary osteotomy of the femur is a safe and effective technique for correcting rotational deformities of the femur although demanding in terms of experience and equipment.