ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
Deep peroneal nerve has a potential risk of injury during open-wedge high tibial osteotomy.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 17 citations in OpenAlex.
- Postoperative alignment and patients reported outcome measures improvement after high tibial osteotomy: a significant interaction with osteoarthritis severity.Archives of orthopaedic and trauma surgery · 2026Article
- Medial degenerative disease of the knee without radiographic osteoarthritis is a good indication for medial open wedge high tibial osteotomy.Archives of orthopaedic and trauma surgery · 2024Article
- Open-wedge high tibial osteotomy with a slight valgus correction from neutral limb alignment achieves clinical improvements comparable with those for knees with varus deformity.Journal of experimental orthopaedics · 2023Article
- Tibial shaft fracture after medial open-wedge distal tibial tuberosity osteotomy: A case report.Clinical case reports · 2022Article
- Open Wedge High Tibial Osteotomy with Pes Anserinus Preservation and Insertion of Bone Substitutes.Arthroscopy techniques · 2022Article
- [Correction of complex defomities around the Knee Joint].Der Orthopade · 2021Review
- Early experience using patient-specific instrumentation in opening wedge high tibial osteotomy.International orthopaedics · 2021Observational
- Monocortical fixation for locking plate distal screws does not impair mechanical properties in open-wedge high tibial osteotomy.BMC musculoskeletal disorders · 2021Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the risk of injury to the neurovascular bundle on the interosseous membrane of the leg during drilling for distal screw insertion in open-wedge high tibial osteotomy (OWHTO), and to investigate the possible influence of the method of plate placement on the risk.
methodsThis retrospective study involved, 55 patients (32 with a TomoFix plate, 23 with a TriS plate) who underwent postoperative CT scanning of the knee following OWHTO between 2009 and 2018. The angle and position of the locking plate, and the direction of screw insertion relative to the interosseous membrane were analysed.
resultsAll distal screws had a risk of neurovascular injury. In particular, 25 screws at the #4 hole (45%) had an extended insertion trajectory that intersected with the interosseous membrane. The angle of the proximal part of the TomoFix plate was a significant risk factor. In contrast, methods of TriS plate placement showed no statistically significant differences.
conclusionsExtended insertion trajectories of distal screws were likely to intersect with the interosseous membrane with the neurovascular bundle potentially on its surface; thus, drilling for bicortical fixation posed a risk of neurovascular injury. The risk increased as the TomoFix plate was placed more medially, suggesting that bicortical drilling must be performed with the utmost attention when the plate is placed at the medial position. Given the particularly high risk at the #3 and #4 screw holes, monocortical fixation of a few distal screws is recommended as long as good stability is ensured.
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