PediLoc ® Extension Osteotomy
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PediLoc® Extension Osteotomy Plate (PLEO) Left PLEO Plates Sizes: 6, 8 and 10 hole plates Right PLEO Plates Sizes: 6, 8 and 10 hole plates

PediLoc® Extension Osteotomy Plate The technique description herein is made available to the healthcare professional to illustrate the author’s suggested treatment for the uncomplicated procedure. In the final analysis, the preferred treatment is that which addresses the needs of the specific patient. PediLoc® Extension Osteotomy Plating System Surgical Technique Introduction PediLoc® Extension Osteotomy Plate . . . . . . . . . . . . . . .2 Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Background . . . . . . . . . . . . . . . . . . . . . . . . ....

Severe knee flexion contractures in children remain a difficult treatment problem. This technique will be used primarily for patients with persistent knee flexion contracture during the stance phase of gait, most of whom have cerebral palsy. Residual static knee flexion contracture is treated by a compensatory osteotomy of the distal femur of the exact same degree as the knee flexion contracture. • In many cases this procedure is either preceded, or accompanied by, a hamstring lengthening. • In most cases the procedure should be accompanied by a patellar tendon shortening or alternatively,...

Surgical Procedure Preparation Determine the extent of distal femoral extension desired. The degree of distal femoral extension is determined from clinical examination and a lateral x-ray of the knee in maximum extension. Measure the tibio-femoral angle on the lateral projection. Patient Positioning Position the patient supine on a radiolucent operating table. Visualization of the hip, knee and ankle joint with the image intensifier is necessary. Prep and drape the affected lower extremity up to the hip. Drape to allow maximal exposure of the hip as well the lower extremity. If a sterile...

Surgical Approach Position Implant Using fluoroscopy, mark out the level of the distal femoral physis. Make a standard lateral approach to the distal femur If planning a concomitant patellar tendon shortening then curve the distal portion of the incision anteriorly over the patellar tendon. Place a guide wire (2mm k-wire) parallel to and just proximal to the distal femoral physis, slightly anterior to the midpoint of the femur. This will help later with translation. Slide the plate over the guide wire to ensure that all the screw holes in the distal flared portion of the plate will engage...

Surgical Procedure Position Implant Using fluoroscopy, hold the plate against the shaft of the distal lateral femur. Sometimes the plate will need to be contoured to prevent excess valgus following osteotomy. Utilize the threaded drill guides in the distal holes while contouring to prevent damage to the internal threads. Provisional Plate Fixation Place the knee in the maximally extended position. Using the distal targeting guide with handle, align the plate with the long axis of the tibia. Or, alternatively, use the plate as your guide and align the plate to the long axis of the tibia. In...

Perform Osteotomy Attach Plate Using an oscillating saw, cut the femur perpendicular to the long axis of the femur. Make a second cut to match the angle of correction desired and remove the wedge of bone. Once the osteotomy is completed, perform a trial reduction. Pay careful attention to the tension created posteriorly and also to translation. The distal fragment should be translated posteriorly to minimize the anterior bump. At this point the femora-tibial angle should be 0 degrees with the former flexion angle now shifted to the osteotomy site. Once trial reduction looks satisfactory,...

PediLoc® Extension Osteotomy to be used in conjunction with PediLoc® Small Fragment (3.5mm) and PediLoc® Large Fragment (4.5mm). CAUTION: Federal law restricts this device to sale by or on the order of a Physician. CAUTION: Devices are supplied Non-Sterile. Clean and sterilize before use according to instructions. CAUTION: Implant components are single-use. Do not reuse. CAUTION: This device is not approved for screw attachment or fixation to the posterior elements (pedicles) of the cervical, thoracic or lumbar spine. This document is intended exclusively for experts in the field, i.e....