An Acute Oblique Osteotomy and Suture Ligation Procedure to Shorten the Fibula in Lateral Closing‐Wedge High Tibial Osteotomy
Kazunori Yasuda, Eiji Kondo, Daisuke Ueda, Jun Onodera, Koji Yabuuchi, Yoshie Tanabe, Norimasa Iwasaki, Tomonori Yagi
Abstract
The purpose of this description is to report an "acute oblique osteotomy and ligation" (AOOL) procedure to shorten the fibula in high tibial osteotomy (HTO). A 4-cm longitudinal skin incision is made at the lateral aspect of the leg. After the central portion of the fibula is circumferentially isolated from all the periosteal tissues, a simple osteotomy is performed at the mid-portion of the fibular diaphysis in the quasi-frontal plane, which is inclined by 25 to 30° to the long axis of the fibula. Two thin holes are created beside the osteotomy line on the lateral surface of the fibula. A polyester thread is passed through the 2 holes. After the HTO is completed, the surgeon easily reduces the displaced fibular ends using this thread. This thread is securely tied to keep the contact between the 2 osteotomized surfaces. The AOOL procedure is technically easy and safely performed. We believe that the AOOL procedure is clinically useful to shorten the fibular shaft in HTO.