PMC6503814_01
Preoperative 3D-CT.. Abbreviations: 3D-CT, three-dimensional computed tomography.
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Radiograph, CT scan, and 3D-CT assessments revealed varus deformity in her supracondylar femur as well as a valgus deformity in her proximal tibial diaphysis and patella baja (Figure 1).
Preoperative full-length, weight-bearing lower extremity anteroposterior view.
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A long-standing anteroposterior radiograph confirmed 17  of varus femoral deformity and 14  of valgus tibial deformity, with the mechanical axis passing just medial to her tibial plateau (Figure 2).
Intraoperative radiograph showing the intra-articular bone resections made parallelly to the preexisting joint obliquity (white arrows), osteotomized tibial tubercle (gray arrows), and insertion of Kirschner wire in the area of the planned tibial osteotomy (black arrow).
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Next, the midline incision was extended distally; the closing wedge osteotomy was made medially based at the apex of the tibial deformity under C-arm guidance (Figure 3).
Postoperative radiograph taken at 5-year follow-up. (A) Anteroposterior view and (B) lateral view.
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All osteotomy sites were radiographically healed (Figure 4); limb alignment (weight-bearing full-length X-ray measurements) was corrected from a combined 17  of femoral varus and 14  of tibial valgus deformity pre-operatively to 6  of femoral varus postoperatively.