Upper tibial valgus osteotomy using a dynamic external fixator

Abstract

Upper tibial valgus osteotomy has its difficulties and complications, including peroneal nerve palsy and vascular impairment when external fixation devices have penetrated the anterior compartment (Coventry 1985). Gibson et al (1986) found a significant increase in compartment pressure in seven of ten closing wedge osteotomies which were not drained; this pressure increase or direct damage to the peroneal nerve may produce the palsy. Fibular osteotomy may cause paralysis of the extensor hallucis longus. We have used since 1983 a method of osteotomy, as described by Turi et al (1987) which uses a single-bar dynamic axial fixator and a medially-based opening wedge corticotomy. This appears to reduce the risk of these complications.