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(A) With the osteotomy site well opposed and compressed, a large Richards staple (Smith & Nephew) is placed just medial to the midline to hold the osteotomy closed in a right knee. (B) Keeping the leg in hyperextension, 2 additional large staples are placed to help secure the osteotomy site. The use of 3 staples for the closing wedge osteotomy fixation allows for quick, low-profile fixation when the posterior cortex remains intact.
