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The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P. Barei, Glenn A. Brien, and Scott E. Porter JBJS Essent Surg Tech Volume os-92(Supplement 1 Part 2):158-175 September 1, 2010 ©2010 by The Journal of Bone and Joint Surgery, Inc.

The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

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Page 1: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions

by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P. Barei, Glenn A. Brien, and Scott E. Porter

JBJS Essent Surg TechVolume os-92(Supplement 1 Part 2):158-175

September 1, 2010

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 2: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 3: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 4: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 5: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 6: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 7: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 8: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 9: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Fig. 1-H The osteotomy gaps are successively filled with reamings.

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 10: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 11: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 12: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 13: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 14: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 15: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 16: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 17: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 18: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 19: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 20: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 21: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 22: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 23: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 24: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Fig. 3 Artist's depiction of the plane of the longitudinal portion of the clamshell osteotomy for the tibia.

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 25: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 26: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 27: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 28: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 29: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 30: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 31: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.

Page 32: The Clamshell Osteotomy: A New Technique to Correct Complex Diaphyseal Malunions by George V. Russell, Matt L. Graves, Michael T. Archdeacon, David P

Russell G V et al. J Bone Joint Surg Am 2010;os-92:158-175

©2010 by The Journal of Bone and Joint Surgery, Inc.