Table 2.

Pearls and Pitfalls

Pearls

•A 2-mm K wire should be percutaneously inserted from the edge of the lateral tibial plateau to the distal tibia to protect the lateral cortex of the tibia during dome osteotomy and gap opening.

•Two to three 1.2-mm K wires should be percutaneously inserted just below the tibial plateau to protect hinge area during gap opening.

•Valgus correction of the tibia should be performed slowly to prevent hinge fracture.

Pitfalls

•There is a risk of neurovascular injury during osteotomy. A careful approach and protection with radiolucent retractor reduce the risk of injury.

•All the osteotomies must be checked to ensure that they are completed with the intact hinge area to prevent iatrogenic fracture.