[Open-wedge retro-tubercular tibial osteotomy: an innovating technique]

Open-wedge tibial osteotomy for varus correction is a common orthopedic procedure. The rate of complications remains significant: loss of correction, nonunion, patellar infera... We propose a new open-wedge technique for tibial osteotomy which has several advantages: less risk of patella infera, improved bone healing, excellent mechanical stability. The osteotomy involves two cuts with an anterior portion ending distally to the tibial tubercle. This preserves the integrity of the patellar tendon and maintains contact between the proximal tibia and the tibial tubercle. Adjunction of an anteroposterior screw adds stability. The anterior plane of the osteotomy provides an excellent surface contact favoring bone healing. The posterior plane is the same as with a "classical" open-wedge osteotomy. The lateral cortical must always remain intact (hinge). The technique described here does not require any specific instrumentation and is compatible with most of the available osteosynthesis implants.