A Technical Tip to Treat the Intraoperative Lateral Cortex Fracture during a Medial Open-wedge High Tibial Osteotomy

Abstract

Instability at the open-wedge osteotomy site due to disruption of the lateral cortex may contribute to displacement and may thus bring about delayed union or nonunion and recurrent varus deformity. Lateral cortex fracture in the medial open-wedge High Tibial Osteotomy (HTO) is an unstable situation, so surgeons can’t achieve primary stability on the osteotomy site easily. To our knowledge, despite being a feared complication, there are few reports dealing with the treatment for intraoperative lateral cortex fracture in the literatures. So, we present a case of intraoperative lateral cortex fracture during an open-wedge HTO and a simple technical tip to achieve primary stability. The use of Schanz pin on the tibial shaft is simple, improves the stability during fixation of plate and can be used to prevent the hinge dislocation during open-wedge HTO. But meticulous surgical procedures may help to decrease the incidence of unintentional lateral cortex fracture.