title: Correction of multiple complex lower limb deformities by intramedullary nailing.
abstract: A female patient presented to our institution suffering from long bone post-traumatic multiple deformities. Her walking was limited, painful and teetering. It had worsened over the past months. The right leg was shortened by 6 cm compared to the contralateral. The right femur was 18° varus, the right tibia was 16° valgus, the left tibia was 12° varus. Both knee joints showed marked radiographic signs of osteosclerosis. After a thorough study with simulations using paper models, we carried out three osteotomies, two open wedge and one cuneiform, stabilizing them with intramedullary nails. We conducted the operation in two stages, in order to avoid an excessive surgical stress that could give rise to complications such as DVT, fat embolism, and respiratory insufficiency. This allowed a rapid recovery of her weight bearing and walking capacity, reducing significantly also the leg length discrepancy. She progressed uneventfully to healing of the osteotomy sites and she returned to her previous occupation.
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata di Verona, Italy. Electronic address: guidofly56@gmail.com.
authors.forename: Guido
authors.initials: G
authors.lastname: Rocca
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Spina
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Carpeggiani
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Schirru
mesh_terms: D000328:Adult; D005260:Female; D005264:Femoral Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016138:Walking; D016474:Weight-Bearing
keywords: cuneiform and open wedge osteotomy; deformities; intramedullary nailing; long bone multiple post-traumatic axial; long bone osteotomies