26dkou438 10.3205/26dkou438 urn:nbn:de:0183-26dkou4385 Meeting Abstract Rincón Mora Rincón Mora Cristian Eduardo CE

Clínica Palermo, Bogotá, Kolumbien

author Jimenez Cortes Jimenez Cortes Diego de Francisco DdF

Clínica Palermo, Bogotá, Kolumbien

author Hernandez Agudelo Hernandez Agudelo Ivan Mauricio IM

Clínica Palermo, Bogotá, Kolumbien

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 438 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Poster | Gestörte Frakturheilung und Komplikationsmanagement Berlin 20261020 20261023 DKOU26_Abs_2399 TextObjectives and questions: To present a complex femoral reconstruction using a modified clamshell osteotomy assisted by three-dimensional (3D) preoperative planning, aimed at achieving simultaneous correction of limb length discrepancy, angular deformity, and rotational malalignment in a post-traumatic femoral deformity.Material and methods: We prospectively report the case of a 54-year-old male with a history of intertrochanteric and subtrochanteric femoral fracture secondary to a high-energy traffic accident, initially treated with cephalomedullary nailing. The patient evolved with malunion and subtrochanteric nonunion, resulting in a 6 cm limb length discrepancy. A subsequent bone transport procedure reduced the discrepancy to 2.7 cm; however, persistent proximal femoral malrotation of 12° remained, associated with significant gait impairment and mechanical axis deviation.Preoperative 3D reconstruction and planning were performed using the contralateral femur as a template to define the magnitude of rotational correction and required length restoration. A modified femoral clamshell osteotomy was designed to allow controlled multiplanar correction and stable intramedullary fixation in a single-stage procedure (Figure 1 ). As this is a single-case prospective report, outcomes were evaluated descriptively through clinical and radiographic follow-up without inferential statistical analysis.Results: The modified clamshell technique enabled accurate correction of the 12° rotational deformity, restoration of the residual 2.7 cm limb length discrepancy, and re-establishment of the mechanical axis. Intraoperative alignment corresponded closely with the preoperative 3D plan. At 3-month follow-up, the patient demonstrated progressive radiographic consolidation, substantial improvement in gait mechanics, and maintenance of length and rotational correction.Discussion and conclusions: 3D-assisted modified clamshell osteotomy represents a strategy for the management of complex femoral deformities, allowing precise, reproducible, and simultaneous correction of rotational and longitudinal discrepancies. The use of contralateral anatomical referencing enhances surgical accuracy and may reduce residual deformity. 0

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