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A “safe zone” in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this cadaveric study was to study the effect of plane of osteotomy on incidence of lateral cortex fracture and to define a “safe zone” through which medial open-wedge high tibial osteotomy (HTO) could be performed with minimal risk of lateral cortex fracture.

Methods

Medial open HTO was performed in nine fresh frozen human cadavers (18 knees) with each specimen randomly assigned to a “safe zone” osteotomy (group A, between the tip of the fibular head and the circumference line of the fibular head,) or a lower level osteotomy (group B, distal to the circumference line of the fibular head).

Results

Six out of nine knees developed lateral cortex fracture in group B compared to none in group A (P = 0.009) when the osteotomy site was distracted to a maximum of 20 mm.

Conclusion

Directing the plane of the osteotomy toward the “safe zone” significantly reduces the risk of lateral cortex fracture compared to an osteotomy, which is directed at a lower level. Confining the plane of a medial open HTO to within the “safe zone” can prevent lateral cortex fracture and subsequent loss of correction.

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Acknowledgments

This study is supported by 2009 Inje university research grant.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ilsanpaik Hospital, Inje University, Ilsan, Korea

    Seung Boem Han, Jae Gwang Song & Kyung Wook Nha

  2. Department of Orthopaedic Surgery, Anam Hospital, Korea University, Seoul, Korea

    Seung Boem Han & Dae Hee Lee

  3. Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India

    Gautam M. Shetty

  4. Department of Orthopaedic Surgery, Bonplus Hospital, Seoul, Korea

    Dong Ju Chae

Authors
  1. Seung Boem Han
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  2. Dae Hee Lee
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  3. Gautam M. Shetty
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  4. Dong Ju Chae
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  5. Jae Gwang Song
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  6. Kyung Wook Nha
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Corresponding author

Correspondence to Kyung Wook Nha.

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Han, S.B., Lee, D.H., Shetty, G.M. et al. A “safe zone” in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc 21, 90–95 (2013). https://doi.org/10.1007/s00167-011-1706-7

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  • DOI: https://doi.org/10.1007/s00167-011-1706-7

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