LIVRE JDG 2010

JOURNÉES LYONNAISES DE CHIRURGIE DU GENOU

Fig. 3-A, 3-B: (Figs. reprinted, with permission, from: Marti RK, Kerkhoffs GM. Osteotomies

for malunions of the tibial head. In: Marti RK, van Heerwaarden RJ, editors. Osteotomies for

posttraumatic deformities. New York: Thieme; 2008. p 479-94.) Fig. 3-A Intra-articular cor-

rection is performed through the extended arthrotomy and the opening wedge osteotomy.

The depressed cartilage zone is marked circumferentially with a 2-mm drill-bit, either from

proximal as shown here or from distal through the proximal tibial osteotomy. Fig. 3-B After

the depressed plateau zone is marked with passes of a small drill-bit, the passes are connec-

ted with an osteotome before the complete zone can be elevated.

Fig. 4A, 4B :

4a: (Figs. Reprinted from: Kerkhoffs GMMJ et al. J Bone Joint Surg Am. 2009; 91 Suppl: 101-

1). With use of a curved impactor inserted through the window, the depressed area of the pla-

teau is elevated to conform to the lateral femoral condyle. 4b: To conform to the lateral femo-

ral condyle in both extension and flexion, an overcorrection of 1 mm is created. The correc-

tion is maintained by impacting cancellous autograft bone beneath the elevated segment