Fig 8.

Left knee pin placement for opening-wedge distal femoral osteotomy with patient in supine position. Two pins (white arrows) are placed in the desired location for the opening-wedge distal femoral osteotomy. An osteotomy guide is placed between the pins to delineate the cutting plane for the osteotomy. The osteotomy is completed using a saw cutting to a depth of 5 mm, followed by a variety of osteotomes to cut through the bone. A 1-cm medial cortical hinge should be maintained and verified by fluoroscopy.