Corrective Osteotomy: Paleys Method

Limb deformities are mostly the result of premature closure of a growth plate or malunion of fractures. Developmental conditions in the femur and tibia can cause varus or valgus deformations with patellar with luxations as a consequence. Alignment of the deformity is challenging in both human and veterinary medicine. Paleys method describes a technique where, through careful preoperative measurements on radiographs, the correction can be achieved by 1 single closing wedge osteotomy in order to correct all angles of the deformity. Proximal and distal joint angles are determined by drawing joint orientation lines. This is the angle between the anatomical axis of the diaphysis end the tangential line through the joint space. For the radius in the frontal (craniocaudal) plane, the angles are the anatomic medial proximal radial angle (aMPRA) and the anatomic lateral distal radial anatomic angle (aLDRA). In the sagittal (mediolateral) plane, the anatomic cranial proximal radial angle (aCrPRA) and anatomic caudal distal radial angle (aCdDRA) are determined. […]