Fig 11.

Left knee osteotomy site closure for the anterior closing-wedge proximal tibial osteotomy with the patient in the supine position. After the bone from the wedge is removed, the osteotomy site (white arrow) should be slowly closed. Pressure should be maintained with a hand above the patella and the knee is hyperextended to close the osteotomy site. Visualization and palpation with a finger should be performed to ensure proper closure of the wedge. Once the site is closed, 3 Richard staples will be used to hold the osteotomy site closed.