Surgical procedure for modified CWHTO. (A) A curvilinear incision was made over the lateral aspect of the proximal tibia, and a 3–4-cm incision was made over the lateral aspect of the leg at the level centered about 15 cm distal to fibular head. (B) The extensor muscles were detached to expose the lateral tibial cortex. The osteotomy site was at the distal third of the tibial tuberosity. Two K-wires were drilled in as osteotomy guides. (C) The cut was initiated with a saw under constant irrigation and completed with an osteotome. The hinge of the medial cortex was carefully penetrated with the use of a drill instead of an osteotome. (D) The wedge was closed and the frontal alignment was checked with a cautery cord. (E) An L-shaped LCP plate was inserted for internal fixation. The proximal part of the plate was placed at the level of Gerdy’s tubercle. The shaft of the plate was aligned to the longitudinal axis of the tibia. A full contact between the plate and the bone surface was not necessary.