Ankle-Angle-Adjusting Fibular Osteotomy in Closed Wedge High Tibial Osteotomy

• DOI: 10.1016/j.eats.2022.08.018
• Publication Date: 2022-11-17T06:05:08Z
• Authors: Ryuichi Nakamura; Masaki Amemiya; Fumiyoshi Kawashima; Akira Okano
• Keywords: High tibial osteotomy; Superficial peroneal nerve

Closed-wedge high tibial osteotomy (CWHTO) may be carried out to realign the knee in patients with osteoarthritis who do not meet criteria for open-wedge or total arthroplasty. The procedure involves both fibular and osteotomy, care is needed prevent peroneal nerve vessel injury during osteotomy. Notably, use of a tourniquet mask development hematomas aneurysms until after surgery. We developed 3-step ankle-angle-adjusting (triple-A) technique relax muscles, allowing easy retraction vessels. Crucially, does require tourniquet, thus bleeding detected stopped process adjusting ankle angle by plantar-flexion applying varus stress highlight tension difference between lateral posterior compartments; great toe loosen flexor hallucis longus muscle, exposing aspect; valgus peroneus muscle. muscles can then retracted sufficiently allow distal proximal osteotomies performed, any resolved before wound closure. This improve ease safety undergoing CWHTO.