Compared with a lateral closing wedge high tibial osteotomy, a distinct advantage of the medial opening wedge high tibial osteotomy is:
- A It achieves faster regenerate consolidation
- B It does not require a fibular osteotomy, avoiding risk to the common peroneal nerve ✓
- C It permits correction of much larger degrees of deformity
- D It eliminates the need for any internal fixation
Correct answer: B. It does not require a fibular osteotomy, avoiding risk to the common peroneal nerve
Explanation
The opening wedge is made medially below the tibial tubercle through a single cut, so the fibula and the proximal tibiofibular joint are left undisturbed and the common peroneal nerve, which winds around the fibular neck, is never at risk. Closing wedge osteotomies need a fibular osteotomy or joint disruption. Both techniques require fixation, usually a locking plate for the opening wedge.
Reference: Insall & Scott Surgery of the Knee, 6th ed.
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