{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T13:05:51Z","timestamp":1784898351743,"version":"3.55.0"},"reference-count":39,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal-cot.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Orthopaedics and Trauma"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.jcot.2026.103428","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T15:03:07Z","timestamp":1776697387000},"page":"103428","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Distal femoral malunion: Biomechanical drivers, fixation strategies and the role of fixator assisted correction"],"prefix":"10.1016","volume":"77","author":[{"given":"Jonathan James","family":"D'souza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Peterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcot.2026.103428_bib1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/01.blo.0000197079.26600.09","article-title":"Rotational changes at the knee after ACL injury cause cartilage thinning","volume":"442","author":"Andriacchi","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jcot.2026.103428_bib2","series-title":"Principles of Deformity Correction","author":"Paley","year":"2002"},{"issue":"7","key":"10.1016\/j.jcot.2026.103428_bib3","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1002\/1529-0131(199807)41:7<1233::AID-ART14>3.0.CO;2-L","article-title":"Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis","volume":"41","author":"Sharma","year":"1998","journal-title":"Arthritis Rheum"},{"issue":"Suppl 1","key":"10.1016\/j.jcot.2026.103428_bib4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2106\/JBJS.H.01408","article-title":"Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee","volume":"91","author":"Andriacchi","year":"2009","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"10.1016\/j.jcot.2026.103428_bib5","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1136\/ard.61.7.617","article-title":"Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis","volume":"61","author":"Miyazaki","year":"2002","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"10.1016\/j.jcot.2026.103428_bib6","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s00264-017-3665-1","article-title":"Population-based epidemiology and incidence of distal femur fractures","volume":"42","author":"Elsoe","year":"2018","journal-title":"Int Orthop"},{"issue":"4","key":"10.1016\/j.jcot.2026.103428_bib7","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.injury.2023.02.037","article-title":"Periprosthetic distal femur fractures around total knee replacements: a comprehensive review","volume":"54","author":"Al-Jabri","year":"2023","journal-title":"Injury"},{"issue":"1","key":"10.1016\/j.jcot.2026.103428_bib8","first-page":"27","article-title":"Varus collapse of comminuted distal femur fractures after open reduction and internal fixation with a lateral condylar buttress plate","volume":"32","author":"Davison","year":"2003","journal-title":"Am J Orthop (Belle Mead NJ)"},{"issue":"6","key":"10.1016\/j.jcot.2026.103428_bib9","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/BOT.0b013e318234d460","article-title":"Comparison of the 95-degree angled blade plate and the locking condylar plate for the treatment of distal femoral fractures","volume":"26","author":"Vallier","year":"2012","journal-title":"J Orthop Trauma"},{"key":"10.1016\/j.jcot.2026.103428_bib10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/1749-799X-8-43","article-title":"Clinical outcomes of locked plating of distal femoral fractures in a retrospective cohort","volume":"8","author":"Hoffmann","year":"2013","journal-title":"J Orthop Surg Res"},{"issue":"2","key":"10.1016\/j.jcot.2026.103428_bib11","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/BOT.0b013e31829e6dd0","article-title":"Risk factors for failure of locked plate fixation of distal femur fractures: an analysis of 335 cases","volume":"28","author":"Ricci","year":"2014","journal-title":"J Orthop Trauma"},{"issue":"6","key":"10.1016\/j.jcot.2026.103428_bib12","first-page":"354","article-title":"Preoperative planning of orthopedic procedures using digitalized software systems","volume":"18","author":"Steinberg","year":"2016","journal-title":"Isr Med Assoc J"},{"issue":"2","key":"10.1016\/j.jcot.2026.103428_bib13","doi-asserted-by":"crossref","first-page":"72","DOI":"10.5005\/jp-journals-10080-1425","article-title":"Bone ninja Mobile app for reverse planning method in internal limb deformity and lengthening surgery","volume":"14","author":"Hung","year":"2019","journal-title":"Strategies Trauma Limb Reconstr"},{"issue":"5","key":"10.1016\/j.jcot.2026.103428_bib14","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s11832-016-0761-5","article-title":"Comparison of PACS and bone ninja mobile application for assessment of lower extremity limb length discrepancy and alignment","volume":"10","author":"Whitaker","year":"2016","journal-title":"J Child Orthop"},{"issue":"12","key":"10.1016\/j.jcot.2026.103428_bib15","doi-asserted-by":"crossref","first-page":"2910","DOI":"10.1007\/s11999-008-0524-9","article-title":"Methods for assessing leg length discrepancy","volume":"466","author":"Sabharwal","year":"2008","journal-title":"Clin Orthop Relat Res"},{"issue":"7","key":"10.1016\/j.jcot.2026.103428_bib16","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1007\/s00402-021-03831-1","article-title":"Distance from the magnification device contributes to differences in lower leg length measured in patients with TSF correction","volume":"142","author":"Ahrend","year":"2022","journal-title":"Arch Orthop Trauma Surg"},{"issue":"3","key":"10.1016\/j.jcot.2026.103428_bib17","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/0268-0890(94)90053-1","article-title":"Part 1: corrective osteotomies for lower limb deformities","volume":"8","author":"Paley","year":"1994","journal-title":"Curr Orthop"},{"issue":"4","key":"10.1016\/j.jcot.2026.103428_bib18","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/0268-0890(94)90024-8","article-title":"Part 2: corrective osteotomies for lower limb deformities","volume":"8","author":"Paley","year":"1994","journal-title":"Curr Orthop"},{"issue":"1","key":"10.1016\/j.jcot.2026.103428_bib19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/0268-0890(95)90048-9","article-title":"Part 3: corrective osteotomies for lower limb deformities","volume":"9","author":"Paley","year":"1995","journal-title":"Curr Orthop"},{"issue":"2","key":"10.1016\/j.jcot.2026.103428_bib20","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/0268-0890(95)90071-3","article-title":"Part 4: corrective osteotomies for lower limb deformities","volume":"9","author":"Paley","year":"1995","journal-title":"Curr Orthop"},{"issue":"3","key":"10.1016\/j.jcot.2026.103428_bib21","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s11751-016-0265-3","article-title":"The use of blocking screws with internal lengthening nail and reverse rule of thumb for blocking screws in limb lengthening and deformity correction surgery","volume":"11","author":"Muthusamy","year":"2016","journal-title":"Strategies Trauma Limb Reconstr"},{"issue":"11","key":"10.1016\/j.jcot.2026.103428_bib22","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.3390\/medicina61112050","article-title":"Femoral malunion and its correction: a review","volume":"61","author":"Vaidya","year":"2025","journal-title":"Medicina (Kaunas)"},{"issue":"10","key":"10.1016\/j.jcot.2026.103428_bib23","article-title":"Interventions for treating fractures of the distal femur in adults","volume":"10","author":"Claireaux","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"issue":"2 suppl l","key":"10.1016\/j.jcot.2026.103428_bib24","article-title":"Distal femur fractures: basic science and international perspectives","volume":"7","author":"Nauth","year":"2024","journal-title":"OTA Int"},{"issue":"2","key":"10.1016\/j.jcot.2026.103428_bib25","doi-asserted-by":"crossref","first-page":"77","DOI":"10.5005\/jp-journals-10080-1430","article-title":"Blocking screw-assisted intramedullary nailing using the reverse-rule-of-thumbs for limb lengthening and deformity correction","volume":"14","author":"Dabash","year":"2019","journal-title":"Strategies Trauma Limb Reconstr"},{"issue":"1","key":"10.1016\/j.jcot.2026.103428_bib26","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12891-020-3075-1","article-title":"The impact of mal-angulated femoral rotational osteotomies on mechanical leg axis: a computer simulation model","volume":"21","author":"Jud","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"issue":"11","key":"10.1016\/j.jcot.2026.103428_bib27","doi-asserted-by":"crossref","first-page":"2740","DOI":"10.1007\/s00167-013-2618-5","article-title":"The effects of femoral external derotational osteotomy on frontal plane alignment","volume":"22","author":"Nelitz","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"9","key":"10.1016\/j.jcot.2026.103428_bib28","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1302\/0301-620X.94B9.28672","article-title":"The effect on mechanical axis deviation of femoral lengthening with an intramedullary telescopic nail","volume":"94","author":"Burghardt","year":"2012","journal-title":"J Bone Joint Surg Br"},{"issue":"2","key":"10.1016\/j.jcot.2026.103428_bib29","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s00064-009-1709-4","article-title":"The reverse planning method for lengthening of the lower limb using a straight intramedullary nail with or without deformity correction. A new method","volume":"21","author":"Baumgart","year":"2009","journal-title":"Oper Orthop Traumatol"},{"issue":"3","key":"10.1016\/j.jcot.2026.103428_bib30","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s11751-017-0296-4","article-title":"The history, evolution and basic science of osteotomy techniques","volume":"12","author":"Dabis","year":"2017","journal-title":"Strategies Trauma Limb Reconstr"},{"issue":"6","key":"10.1016\/j.jcot.2026.103428_bib31","article-title":"Ilizarov external fixation: percutaneous gigli saw versus multiple drill-hole osteotomy techniques for distraction osteogenesis","volume":"11","author":"Makhdoom","year":"2019","journal-title":"Cureus"},{"issue":"3","key":"10.1016\/j.jcot.2026.103428_bib32","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ocl.2020.03.001","article-title":"Percutaneous osteotomies in pediatric deformity correction","volume":"51","author":"Nahm","year":"2020","journal-title":"Orthop Clin North Am"},{"issue":"4","key":"10.1016\/j.jcot.2026.103428_bib33","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/00013611-199712000-00004","article-title":"Fixator assisted nailing of femoral and tibial deformities","volume":"12","author":"Paley","year":"1997","journal-title":"Tech Orthop"},{"issue":"1","key":"10.1016\/j.jcot.2026.103428_bib34","doi-asserted-by":"crossref","first-page":"152","DOI":"10.2106\/JBJS.H.00114","article-title":"Fixator assisted acute femoral deformity correction and consecutive lengthening over an intramedullary nail","volume":"91","author":"Kocaoglu","year":"2009","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jcot.2026.103428_bib35","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.amsu.2019.07.006","article-title":"Correction of lower limb deformities with fixator assisted nailing","volume":"45","author":"Wahab","year":"2019","journal-title":"Ann Med Surg"},{"issue":"10","key":"10.1016\/j.jcot.2026.103428_bib36","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1007\/s00264-016-3190-7","article-title":"Prospective comparative study of two methods for fixation after distal femur corrective osteotomy for valgus deformity; retrograde intramedullary nailing versus less invasive stabilization system plating","volume":"40","author":"\u00d6zcan","year":"2016","journal-title":"Int Orthop"},{"issue":"2","key":"10.1016\/j.jcot.2026.103428_bib37","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1302\/0301-620X.99B2.BJJ-2016-0271.R1","article-title":"Computer hexapod-assisted orthopaedic surgery provides a predictable and safe method of femoral deformity correction","volume":"99-B","author":"Hughes","year":"2017","journal-title":"Bone Joint J"},{"issue":"2","key":"10.1016\/j.jcot.2026.103428_bib38","article-title":"Attention to detail: the effect of fluoroscopic parallax on limb alignment assessment during corrective osteotomy","volume":"7","author":"Weldon","year":"2023","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"issue":"11","key":"10.1016\/j.jcot.2026.103428_bib39","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1007\/s00256-014-1972-9","article-title":"A cadaver study comparing intraoperative methods to analyze lower limb alignment","volume":"43","author":"Hawi","year":"2014","journal-title":"Skelet Radiol"}],"updated-by":[{"DOI":"10.1016\/j.jcot.2026.103471","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000}},{"DOI":"10.1016\/j.jcot.2026.103471","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000}}],"container-title":["Journal of Clinical Orthopaedics and Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0976566226000950?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0976566226000950?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T18:40:21Z","timestamp":1780339221000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0976566226000950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":39,"alternative-id":["S0976566226000950"],"URL":"https:\/\/doi.org\/10.1016\/j.jcot.2026.103428","relation":{},"ISSN":["0976-5662"],"issn-type":[{"value":"0976-5662","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Distal femoral malunion: Biomechanical drivers, fixation strategies and the role of fixator assisted correction","name":"articletitle","label":"Article Title"},{"value":"Journal of Clinical Orthopaedics and Trauma","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcot.2026.103428","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Delhi Orthopedic Association. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"103428"}}