Fowler – HTO Opening Wedge

Fowler-HTO Opening Wedge
-templating; 62 % width towards lateral compartment is desired mechanical axis
-mini C-arm
-angle is size of correction to get new mechanical axis
-just ant-sup to PES
-guide wire starting antero-medial and connecting a line with the medial insertion of the patellar tendon and the fibular head
-thin osteotome parallel to wire and account for 10 degree posterior slope of the tibia (ie. higher ant. or you will break through into the joint posteriorly
-insert Arthrex tuning fork to depth of measured width of wedge
-measure alignment using long rod or cautery cord (not accurate b/c of rotational effect
-insert plate with appropriate size block (Puddu plate-tapered or regular)
-4xlarge frag (2 cancellous screws above and 2 cortical screws bellow)
-fill void with 30cc’s bone chips
-biggest correction is 17.5 mm (largest plate)
-always use a drain