Distal Femoral Derotational Osteotomy for Excessive Femoral Anteversion

Excessive femoral anteversion (FA) is an underappreciated contributor to patellar maltracking and instability. Positive screening for anteversion with a hip examination should be followed by computed tomography scan to confirm and quantify the degree of malrotation. Derotational femoral osteotomy allows the surgeon to correct abnormal FA and thereby improve patellar tracking. Correction of the deformity with plate fixation in a supracondylar location has several advantages for reducing morbidity. This article describes our technique for distal derotational femoral osteotomy using a digital inclinometer and plate fixation with standard instrumentation to correct increased FA.