Figure 3

Modified procedure for CWHTO. The osteotomy site was at the distal third of the tibial tuberosity. The procedure was performed under fluoroscopy, and an LCP was inserted for internal fixation. (A) Two K-wires were intraoperatively drilled in as osteotomy guides. The proximal wire was inserted at the level of the distal third of the tibial tuberosity and parallel to the joint line. The distal wire was then inserted in order to indicate the desired angle of correction and exited through the medial cortex where the first wire exited. The angle was determined from preoperative radiographic assessments and confirmed by fluoroscopy. (B, C) AP and lateral radiographs, respectively, 9 months after operation. The proximal fixation screws were at the level of or immediately distal to Gerdy’s tubercle, far from the articular surface. A full contact between the plate and bone surface was not necessary.