ETO believed to be a greater deliverer in revision of a well fixed stem has been a modification of wagner osteotomy which was done in the coronal plane.
One should measure the lenght of the osteotomy preop to get sufficeint cortical scratch fit 6 cm distal to the osteotomy. Longer the oseotomy the weaker the bone to avoid fracture. Predrilling is advisable in early experence to avoid osteotomy propagation. Curving the distal end is advised to avoid stress risers both of which I did not find necessary once good control of the saw is achieved.
Attached are some xrays where in it make efficient use of time and bone,
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| to correct varus remodelling of the proximal femur |
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| easy removal of a well fixed broken stemAdd caption |
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| periprosthetic fracture |
A is anterior , L is lateral. The plane of ETO is the red line. Wagner is the blue line. My only modification of the ETO is the obliquity of the osteotomy in order to increase the contact area. They are usually partial wt bearing for 6 weeks.
In a recent review of our cases by Dr.Vinay, 98% united in 6 months and all by 9 months with less than 2 mm migration
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