[The reliability of percutaneous osteotomy with the Gigli saw technique in the proximal tibia. A cadaveric study].
OBJECTIVE
To evaluate the reliability of percutaneous osteotomy with the use of a Gigli saw in the proximal tibia.


METHODS
Forty-two attendants comprising of residents or consultants without any prior experience were assigned to 14 cadaveric models to perform percutaneous osteotomy. The technique was first described by an experienced specialist and then illustrated on a cadaver specimen. Thereafter, the attendants performed osteotomy using a Gigli saw without any help by the instructors. Finally, exploration of the deep and superficial branches of the fibular nerve, posterior tibial nerve, posterior and anterior artery and vein was made with regard to any injury caused during osteotomy.


RESULTS
There were ten incisional injuries in three specimens due to erroneous determination of the osteotomy level or incision. A mean of 3.5 cm (range 2.5 to 4.0 cm) incision length was observed in four specimens. No procedure-associated injuries to major nerves and vessels were documented except for those to the cutaneous branch of the superficial peroneal nerve in two specimens, and to the extensor hallucis longus muscle in one specimen. There was no incidence of incomplete osteotomy.


CONCLUSIONS
Despite the lack of any prior experience with the osteotomy method with the Gigli saw on the part of the attendants, the full success in performing osteotomy confirms the reliability of the technique. Moreover, if this method is to be used by experienced surgeons, excellent results can be achieved without any injuries to cutaneous nerves and surrounding muscles.
Sen
Cengiz
C
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Gaziosmanpaşa University, 60100 Tokat, Turkey. senc64@yahoo.com
Kocaoğlu
Mehmet
M
Dinçyürek
Hakan
H
Herzenberg
John E
JE
Tanyeli
Ercan
E
Demirci
Selman
S
Vural
Feridun
F
D002102:Cadaver; D006801:Humans; D007719:Knee Joint / Q000098:blood supply / Q000294:innervation; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D011150:Popliteal Artery / Q000293:injuries; D013523:Surgical Equipment; D013978:Tibial Fractures / Q000473:pathology / Q000601:surgery*; D013979:Tibial Nerve / Q000293:injuries