Posttraumatic Deformities of the Lower Limb

Intramedullary nailing is related to malalignment in two quite different constellations: it can be the origin of malalignment and it can be the solution for correction of malalignment. Failed intramedullary nailing can lead to malalignment. On the other hand, intramedullary nails can be used for the surgical treatment of malunion. Early postoperative correction of malalignment is basically superior to later corrective osteotomy. Deformities can be uni- or multidimensional. Uniplanar deformities occur in the frontal, the sagittal or the horizontal plane as well as in torsion. In cases where malunion occurs with an intramedullary nail in place, there are three essential strategies for deformity correction. These are preservation of the medullary nail, exchange of the nail to another nail and removal of the nail with subsequent stabilization using a different type of implant. Correction surgery of posttraumatic deformities is an individual custommade surgery that should include all approved techniques of external and internal fi xation, acute and continuous correction techniques as well as joint replacement procedures.