Oblique tibial osteotomy revisited

PURPOSE Oblique proximal tibial osteotomy is a useful option for correcting deformity associated with Blount's disease (tibia vara). Safe, adequate correction depends on technical issues that have evolved since the original description of the procedure. METHODS Retrospective review of surgical experience. RESULTS The refinement of osteotomy plane orientation, based on the distal rather than the proximal tibia, reduces the likelihood of procurvatum after surgery. The stability of the osteotomy is enhanced by an improved screw fixation technique. The risk of compartment syndrome is low if prophylactic partial fasciotomy is performed concurrently. Avoidance of spinal or regional block anesthesia minimizes the possibility of failure to detect post-operative compartment syndrome. CONCLUSIONS Improvements in the technical execution of oblique proximal tibial osteotomy enhances the correction and predictability of the procedure.