Fig. 15.

This composite figure presents a patient with a malunited diaphyseal femoral fracture with a bended Kuntscher nail in place, ‘Type 6’ knee. Right and left LDFA were 0.5° and 5° in varus, respectively, suggesting a 4.5° acquired frontal femoral deformity. Right and left MPTA were 9° in varus. The plan was to perform a left KA TKA with the nail in place, and to correct the femoral deformity with intra-articular femoral cuts adjustments. The surgeon reproduced the right-side anatomy. Medial soft tissue release was needed to accommodate the 4° of alignment modification.

Note. LDFA, lateral distal femoral angle; MPTA, medial proximal tibial angle; KA, Kinematic Alignment; TKA, total knee arthroplasty.