Novel Approach for Closed Femoral Shortening Osteotomy with Deformity Correction Using Reverse Planning and Retrograde Surgical Technique

Aim: To describe a retrograde femoral shortening technique that allows simultaneous deformity correction over an intramedullary nail.Background: Leg length discrepancy (LLD) can be managed by lengthening the short limb or shortening the long limb, either gradually or acutely.To our knowledge, the combined femoral shortening and deformity correction using a retrograde nail has not been previously reported in the literature.Technique: Shortening and correction are planned using a modified Baumgart reverse-planning method.Based on the planning, the position of the guidewire is replicated intraoperatively.After achieving the "cortical contact" point, further steps are taken for the nail insertion.A percutaneous shortening osteotomy is then performed, with bone and nail alignment controlled using locking and poller screws.Conclusion: This report outlines a reproducible retrograde technique for femoral shortening osteotomy with concurrent deformity correction.Clinical significance: This method provides a safe, technically straightforward, and effective option for treating LLD with associated femoral deformity in the longer limb.