![]() ![]() ![]() The level of the osteotomy on the femur should be as low as possible in the metaphysical bone to prevent bone healing problems. Derotation and correction of varus/valgus alignment can reproducibly be performed with a biplanar technique as described above. This should be checked and corrected to prevent reoperation and failure. Be aware that derotation potentially changes your leg axis. ![]() In many cases it is useful to use a lateral distal approach especially as a lateral lengthening is often necessary and a MPFL reconstruction is recommended in all cases of recurrent patella dislocation. Correction at the level of the femur and tibia can be necessary if excessive internal torsion of the femur and external torsion of the tibia is present. Radiological measurement should be performed by the surgeon for planning of correction. It is very important to measure torsional malalignment with always the same method and according to normal values given by this method. This chapter illustrates the measurement method of lower limb torsion, reports on the indication for a femoral or tibial derotational osteotomy and demonstrates the surgical technique including its aftercare and reported outcome.
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