The physician performs hemiepiphyseal arrest on the distal femur or proximal tibia or fibula. For genu valgus, arrest of the medial femoral physis and/or proximal tibia is performed to realign the knee joint. A 5.0 cm to 7.0 cm, longitudinal incision is made along the lower femur, beginning just above the joint line. The distal femur physis is exposed. Osteotomes excise a rectangular piece of bone from the epiphyseal plate. The growth plate is then drilled in anterior, posterior, and distal directions. A curet is used to remove the growth plate. The physician harvests bone from the patient's hip or femur and closes the surgically created graft donor site. The separately reportable cancellous bone graft is then packed into the defect created by the removal of the growth plate. The rectangular piece of bone is reinserted into its original bed and securely seated with a mallet. The periosteum and incision are repaired in multiple layers.
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