Femoral head reduction osteotomy

The goal of a femoral head reduction osteotomy is to restore a spherical femoral head of normal size, with smooth congruence of the hip joint. Getting there means cutting the proximal femur into several pieces, then putting them back in a new position. Each piece moves. Each cut has to land exactly where it was planned. In this case, the plan removed a wedge of bone, translated the lateral fragment, rotated a second fragment, and refixed the greater trochanter. What ties every step together: two parallel K-wires, placed with the first guide, that stay in the bone for the whole procedure. The first guide cuts the lateral fragment, then slides off along the two wires. The second guide slides on the same way and cuts the resection wedge. Each guide lands exactly where the previous one was, because the wires never move. Once the fragments are in their final position, a third guide slides over the same two wires and pre-drills the paths for the fixation screws across the fragments. Three guides, one shared reference from start to finish.