Opening-Wedge High Tibial Osteotomy with a Locked Low- Profile Plate by Werner Kolb, Hanno Guhlmann, Christoph Windisch, Heiko Koller, Paul Grützner, and.

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Opening-Wedge High Tibial Osteotomy with a Locked Low- Profile Plate by Werner Kolb, Hanno Guhlmann, Christoph Windisch, Heiko Koller, Paul Grützner, and Klaus Kolb JBJS Essent Surg Tech Volume os-92(Supplement 1 Part 2): September 1, 2010 ©2010 by The Journal of Bone and Joint Surgery, Inc.

The procedure is performed with the patient in a supine position and with lateral support. Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

The exposure of the proximal part of the tibia. Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

A Hohmann retractor is placed behind the posteromedial aspect of the tibia to protect the neurovascular bundle. Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 9 The TomoFix is inserted into a subcutaneous tunnel with two temporary spacer bolts. Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 10 The temporary lag screw (red) creates tension in the plate (blue arrows) and compression on the lateral side of the osteotomy (blue arrows). Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 11 Three monocortical self-drilling locking head screws (red) have been inserted distally, and the proximal lag screw has been exchanged for a self-tapping locking head screw (blue). Werner Kolb et al. J Bone Joint Surg Am 2010;os-92: ©2010 by The Journal of Bone and Joint Surgery, Inc.