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Chapter-143 Corrections of Deformity of Limbs

BOOK TITLE: Textbook of Orthopedics & Trauma (4 Volumes)

Author
1. Paley Dror
ISBN
9789385891052
DOI
10.5005/jp/books/12869_144
Edition
3/e
Publishing Year
2016
Pages
50
Author Affiliations
1. Maryland Centre for Limb, Lengthening and Reconstruction, Baltimore, USA, Paley Institute, St Mary’s Hospital, West Palm Beach, Florida 33407, USA, Maryland Centre for Limb Lengthening and Reconstruction, Baltimore, USA
Chapter keywords
Anatomic bone axes, joint orientation, distal anatomic axis, proximal mechanical axis, translation deformity, angulation, multilevel fracture deformity, graphic method, angulation correction axis, sagittal plane

Abstract

This chapter presents a brief discussion on corrections of deformity of limbs and divided into six sections i.e. normal lower limbs alignment and joint orientation, radiographic assessment, frontal plane mechanical and anatomic axis planning, translation and angulation—translation deformities, oblique plane deformities, and sagittal plane deformities. To understand deformities of the lower extremity, it is important to first understand and establish the parameters and limits of normal alignment. The joint lines in the frontal and sagittal planes have a characteristic orientation to the mechanical and anatomic axes. For purpose of communication, it is important to name these angles. Radiographs of lower limbs are obtained in orthogonal reference planes which are frontal plane, anteroposterior (AP) view, sagittal plane and lateral view. The point at which the proximal and distal axis lines intersect is called the center of rotation of angulation (CORA). The axis line of the proximal bone segment is called the proximal mechanical axis (PMA) or proximal anatomic axis (PAA) line, and axis line of the distal bone segment is called the distal mechanical axis (DMA) or distal anatomic axis (DAA) line. Translation deformity is defined as the displacement of the distal segment relative to the proximal segment. The graphic method is an approximate method for determination of angles oblique and plane. Malalignment in the sagittal plane is compensated for by the hip, knee, ankle, subtalar and midfoot joints.

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