Mild angular deformities associated with a mild limb-length discrepancy
of long bones in children can be treated effectively with opening-wedge
osteotomy with insertion of a specially prepared autogenous tricortical
iliac-crest bone graft and with minimum or no internal fixation. Thirty-one
osteotomies in twenty-six children satisfactorily corrected the deformities
so that the angulation and length of the bone were comparable with the
values on the normal, contralateral side. Physeal arrest or ipsilateral
excision of a physeal bar was performed either concomitantly or at a
separate operation in twenty-one of the twenty-six patients, to aid in the
treatment of the limb-length discrepancy. Opening-wedge osteotomy is
applicable for correction when the angular deformity is 25 degrees or less
and the limb-length discrepancy is, or will be, twenty-five millimeters or
less at maturity.