Preoperative planning for lower extremity osteotomies: An analysis using 4 different methods and 3 different osteotomy techniques

Lower extremity osteotomy is a common procedure for managing deformity and unicompartmental gonarthrosis. One consideration not typically addressed is how the osteotomy will affect the leg length of the extremity. This article presents a numerical analysis of apparent leg-length change before and after osteotomy surgery. It also compares the differences resulting from the 3 different major types of osteotomies (closing wedge, opening wedge, and dome). Three different preoperative planning methods and a fourth intraoperative technique were studied. Using different methods of preoperative planning with the same osteotomy technique resulted in leg-length changes of 0.5 to 3 mm. Differences >7° in lower extremity alignment may result depending on the planning method used. When comparing osteotomy techniques, 2 cm in leg-length difference was calculated.