In a lateral closing wedge high tibial osteotomy that requires an associated fibular osteotomy, the fibula should be divided at which level?

• A At the fibular neck
• B At the junction of the upper and middle thirds
• C Just above the lateral malleolus
• D At the junction of the middle and lower thirds ✓

Explanation

The fibular osteotomy for a closing wedge high tibial osteotomy is made at the junction of the middle and lower thirds. This stays clear of the common peroneal nerve as it winds around the fibular neck and also avoids the superficial peroneal nerve in the distal leg, while preserving the interosseous blood supply to the proximal fragment. Excision of the proximal tibiofibular joint is an accepted alternative.

Reference: Insall & Scott Surgery of the Knee, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.