[Wedge osteotomy of the tibial head using fractionated drilling. A complication-reducing surgical modification].
Two techniques of closed wedge osteotomy of the proximal tibia in 132 cases using external fixation device were compared retrospectively for neurological complication rate. While in group 1 (n = 89) wedge osteotomy was performed conventionally using an oscillating saw, in group 2 (n = 43) osteotomy was done with consecutive drill holes of increasing diameter followed by osteoclasis. Neurological complications in group 1 were found postoperatively 15.7% (transient) and after 7 months follow-up time in 12.4% (persistent), in group 2 14% transient and 4.7% persistent neurological deficits were registered. The lower complication rate in group 2 is due to the reduction of postoperative tibialis anterior syndrome (type B lesions). No differences for type C lesions (extension deficit of D1) were found. No complete peroneal palsy (type A) occurred in either group. The authors conclude that reduction of neurological complications in group 2 is related to the less extensive approach of the proposed technique.
Sabo
D
D
Stiftung Orthopädische Universitätsklinik Heidelberg.
Mau
H
H
Bläsius
K
K
D000328:Adult; D000368:Aged; D000868:Anterior Compartment Syndrome / Q000209:etiology; D016267:External Fixators; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D016916:Joint Deformities, Acquired / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D059348:Peripheral Nerve Injuries; D010543:Peroneal Nerve / Q000293:injuries; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*
Tibiakopfvalgisation durch fraktionierte Bohrosteotomie. Eine komplikationssenkende Operationsmodifikation.