A 14-year-old girl with post-traumatic tibial growth arrest develops a progressive tibial length discrepancy of 6 cm with a 15° angular deformity at the site of physeal damage. The Ilizarov technique applied to correct BOTH the angular deformity and the length discrepancy in a single stage using a circular fixator is best described as:

• A Metaphyseal corticotomy with transport segment
• B Distraction epiphysiolysis
• C Trephine corticotomy with acute deformity correction
• D Bifocal osteosynthesis (corticotomy proximal to deformity + deformity correction) ✓

Explanation

Bifocal osteosynthesis (also called bifocal compression-distraction) involves two separate osteotomy/corticotomy sites: one at the deformity (for angular correction) and one at a healthy metaphyseal region (for distraction lengthening). This allows simultaneous angular correction at the deformity site (via acute or gradual correction) and bone lengthening at the regenerate site. It is the technique of choice when significant combined deformity (angulation + shortening) coexists. Single-level corticotomy alone cannot achieve both goals without creating additional deformity.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.