OBJECTIVE: Establish a safe technique for high tibia osteotomy. INDICATIONS: Varus deformity of proximal tibia, high tibia osteotomy indicated. CONTRAINDICATIONS: Correct placement of retractor not possible. SURGICAL TECHNIQUE: Skin incision (6-8 cm) over the medial tibia. Dissection of the Pes anserinus tendons and the medial collateral ligament. Partial release of the distal medial collateral ligament by subperiosteal stripping of the distal part of the ligament. Incision of the gastrocnemius fascia posterior to the medial collateral ligament. Dissection of a soft tissue tunnel between periosteum of the tibia and popliteus muscle. Insertion of retractor, fluoroscopic adjustment in frontal plane according to the planned level of osteotomy. POSTOPERATIVE MANAGEMENT: Postoperative protocol according to the osteotomy technique and implant used. RESULTS: No bleeding complications since introduction of retractor in 22 cases. No changes in standard technique or incision necessary due to use of retractor.
OBJECTIVE: Establish a safe technique for high tibia osteotomy. INDICATIONS: Varus deformity of proximal tibia, high tibia osteotomy indicated. CONTRAINDICATIONS: Correct placement of retractor not possible. SURGICAL TECHNIQUE: Skin incision (6-8 cm) over the medial tibia. Dissection of the Pes anserinus tendons and the medial collateral ligament. Partial release of the distal medial collateral ligament by subperiosteal stripping of the distal part of the ligament. Incision of the gastrocnemius fascia posterior to the medial collateral ligament. Dissection of a soft tissue tunnel between periosteum of the tibia and popliteus muscle. Insertion of retractor, fluoroscopic adjustment in frontal plane according to the planned level of osteotomy. POSTOPERATIVE MANAGEMENT: Postoperative protocol according to the osteotomy technique and implant used. RESULTS: No bleeding complications since introduction of retractor in 22 cases. No changes in standard technique or incision necessary due to use of retractor.