Distal Femoral Flexion Closing Wedge Osteotomy for Treatment of Failed Chronic Distal Femoral Extension Osteotomy in a Patient With Poliomyelitis

The goal of orthopaedic treatment in chronic poliomyelitis is to address the functional impairments resulting from muscular imbalances and bony deformities. The most common knee deformity is a flexion contracture seen in the sagittal plane. Inappropriate or overcorrections of these deformities can have devastating long-term consequences. Revision surgery presents the surgeon with a complex and challenging case with very sparse published literature on revision techniques and osteotomy options. This report describes the successful use of a posterior closing wedge flexion osteotomy with plate fixation to correct a hyperextension deformity caused by a failed or overcorrected extension osteotomy in a 40-year-old man. In this patient, this flexion osteotomy led to complete deformity correction, resolution of symptoms, functional improvement, and return to work without restrictions. (Journal of Surgical Orthopaedic Advances 27(4):329–334, 2018)
Key words: distal femoral flexion closing wedge osteotomy, failed distal femoral extension osteotomy, poliomyelitis