Open Wedge Osteotomy of the Proximal Medial Tibia for Malunited Tibial Plateau Fractures

Abstract

Purpose. To review outcomes of open wedge osteotomy of the proximal medial tibia for malunited tibial plateau fractures. Methods. Seven men (mean age, 36 years) underwent open wedge osteotomy of the proximal medial tibia for instability secondary to malunited tibial plateau fractures of Schatzker types IV (n=3), V (n=1), and VI (n=3). Five patients had been treated conservatively and 2 surgically. Results. Patients were followed up for 12 to 30 months. Five patients achieved complete correction of the deformity, whereas 2 had residual articular surface depression of <2 mm. All patients were satisfied with their improvement in stability and knee function. One patient developed anterior cruciate ligament deficiency and instability and underwent anterior cruciate ligament reconstruction. No patient developed any complication related to wound healing. No delayed loss of correction was observed. Conclusion. Open wedge osteotomy of the proximal medial tibia is recommended for young adults with instability of the knee joint secondary to malunited proximal tibial plateau fractures. The technique is simple and does not require specialised training or any specific instrumentation.