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| 1) | Median parapatellar incision. |
Possible
intra-articular exploration by arthroscopy or short arthrotomy,
Release
of medial tibial metaphysis,
Insertion
of a posterior retractor protecting neurovascular tissues and an anterior
retractor under the patellar tendon at its insertion on the tibial tuberosity.
| 2) | The trial implant indicates the precise position and direction of the osteotomy. |
| Perpendicular
to the tibial diaphysis. |
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| Oblique
superiorly and laterally, passing through the superior edge of the
tibial tuberosity and directed towards the superior extremity of
the heads of the fibula. |
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| A
pin is placed according to these landmarks and its correct position
is confirmed on a x-ray. |
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| 3) | The medial osteotomy is performed by absolutely preserving the lateral aspect. |  |
The
implant, pre-adjusted on the basis of preoperative radiographic calculations,
is positioned in the opening.
Clinical
and radiological assessment of the correction obtained.
The
opening can be increased or decreased at any time during the operation
by simply removing the plate and reajusting the separation.
| Screwing
of the plate |
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| 4) | Postoperative course. |
| No
postoperative immobilization. Immediate
rehabilitation. |
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