The validity of the classification for lateral hinge fractures in open wedge high tibial osteotomy.
The objective of this study was to validate the efficacy of Takeuchi classification for lateral hinge fractures (LHFs) in open wedge high tibial osteotomy (OWHTO). In all 74 osteoarthritic knees (58 females, 16 males; mean age 62.9 years, standard deviation 7.5, 42 to 77) were treated with OWHTO using a TomoFix plate. The knees were divided into non-fracture (59 knees) and LHF (15 knees) groups, and the LHF group was further divided into Takeuchi types I, II, and III (seven, two, and six knees, respectively). The outcomes were assessed pre-operatively and one year after OWHTO. Pre-operative characteristics (age, gender and body mass index) showed no significant difference between the two groups. The mean Japanese Orthopaedic Association score was significantly improved one year after operation regardless of the presence or absence of LHF (p = 0.0015, p < 0.001, respectively). However, six of seven type I cases had no LHF-related complications; both type II cases had delayed union; and of six type III cases, two had delayed union with correction loss and one had overcorrection. These results suggest that Takeuchi type II and III LHFs are structurally unstable compared with type I. Cite this article: Bone Joint J 2015;97-B:1226-31.
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
R
R
Nakamura
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
N
N
Komatsu
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
T
T
Murao
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
Y
Y
Okamoto
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
S
S
Nakamura
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
K
K
Fujita
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
H
H
Nishimura
Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan.
Y
Y
Katsuki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods / Q000534:rehabilitation; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D013977:Tibia / Q000601:surgery*; D013978:Tibial Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing
complication; high tibial osteotomy; knee; osteoarthritis