70 years old woman with minor comorbidities suffered rorabeck type II fr 4 months ago. she was treated with a brace. because of severe valgus deformity she was reffered to me. fracture is healed in 35 degrees valgus and 10 degrees flection. the knee is stable, both components looks well fixed. she is also after hip replacemet. i am planing supracondylar close wedge osteotomy. the bone is quite porotic, the most proximal screw should be at least 2xdiameter of femur below the tip of hip stem. according to my measurement it is possilbe with shortest distal lateral femur plate /synthes or zimmer/ - but it is very close, and there is place for just 3 cortical screws. i am concernning about plate lenght - in this porotic bone is 2xdiameter lenght enough? or should i use long plate extending over hip stem? what is yours opinion about osteotomy Y/N? and plate short/long? or something completely different? thanks.
- supraconylar osteotomy, short plate - proximal screw below tip of hip stem - at least 2xfemur diameter
- supracondylar osteotomy, long plate extending over hip stem