External fixation in proximal tibial osteotomy: a comparison of three methods.

During a period of 6 years (1990-1996), 154 patients with unilateral gonarthrosis underwent proximal tibial osteotomy using 3 different methods of external fixation: (1) closing wedge osteotomy and bilateral fixation; (2) closing wedge osteotomy with unilateral fixation, and (3) opening wedge osteotomy with unilateral fixation. The most common complications were pin-tract infection (25%), temporary nerve palsy (10%), and loss of alignment (17%). At least one complication developed in 33% of patients in this study, indicating that the use and technique of external fixation in proximal tibial osteotomy can be problematic.