Salvage of a failed opening wedge tibial osteotomy using a locking plate.

摘要

Medial opening-wedge high tibial osteotomy has become a popular choice for surgical management of medial compartment arthrosis that is refractory to conservative care. The opening-wedge technique has advantages over a closing-wedge technique: the medial approach is subcutaneous and avoids the lateral approach through the muscle of the anterior compartment, dissection near the peroneal nerve is avoided, and the correction can be "fine-tuned" intra-operatively based on the size of the wedge used to hold open the osteotomy site prior to fixation.1 Furthermore, leg shortening is not an issue with the opening-wedge technique, as can be seen with large angular corrections done by closing-wedge procedures.