21 YR OLD RT. handed student presented with a stiff elbow, jog of rotation Fixed at 90 degrees flexion. She was immobilised in the primary institution for 3 weeks following dislocation which she was mobilised.

Alkaline phosphatase is normal.

MRI shows some radiocapitellar bands

68 year old patient with metaphyseal varus deformity of 22 degrees . Planned for TKR.

Is there a need for a metaphyseal osteotomy? An intraarticular correction of more than 10 degreees may be not advisable,both for longevity as well as medial cortical impingement.

We did a transverse metaphyseal osteotomy where the intramedullary stem impinged the cortex( below the stem tibial base plate junction), used an intramedullary tibial cutting jig. used a distal fitting intramedullary stem and cancellous graft was impacted at the osteotomy site.

She was commenced mobilisation with a walker for 6 weeks.