Lateral hinge fracture in medial opening wedge high tibial osteotomy: a narrative review
Journal
EFORT Open Reviews
ISSN
2058-5241
Date Issued
2023
Author(s)
Nicolás Franulic
José Tomas Muñoz
Piero Innocenti
Nicolás Gaggero
Type
journal-article
Abstract
<jats:p>
<jats:list list-type="bullet">
<jats:list-item>
<jats:p>Lateral hinge fractures (LHF) are one of the most common complications of medial opening wedge high tibial osteotomy (MOWHTO), and are the leading cause of construct instability displacement, non-union, and varus recurrence after this procedure.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>To date, Takeuchi’s classification is the most popular classification to describe this complication, and it can help surgeons to make intra and postoperative decisions.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>Opening medial gap width is the most recognized factor related to LHF occurrence.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>Recognizing the implications of LHF in patients’ clinical and radiographic results has led many authors to propose surgical tips and the use of osteosynthesis materials such as K-wires and screws for its prevention, which should be considered when identifying risk factors for LHF during preoperative planning.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>The evidence for determining the optimal management of LHF is scarce and mostly supported by experts’ opinions and recommendations; therefore, studies are still needed to identify the most appropriate behavior when dealing with such a complication.</jats:p>
</jats:list-item>
</jats:list></jats:p>
<jats:list list-type="bullet">
<jats:list-item>
<jats:p>Lateral hinge fractures (LHF) are one of the most common complications of medial opening wedge high tibial osteotomy (MOWHTO), and are the leading cause of construct instability displacement, non-union, and varus recurrence after this procedure.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>To date, Takeuchi’s classification is the most popular classification to describe this complication, and it can help surgeons to make intra and postoperative decisions.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>Opening medial gap width is the most recognized factor related to LHF occurrence.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>Recognizing the implications of LHF in patients’ clinical and radiographic results has led many authors to propose surgical tips and the use of osteosynthesis materials such as K-wires and screws for its prevention, which should be considered when identifying risk factors for LHF during preoperative planning.</jats:p>
</jats:list-item>
<jats:list-item>
<jats:p>The evidence for determining the optimal management of LHF is scarce and mostly supported by experts’ opinions and recommendations; therefore, studies are still needed to identify the most appropriate behavior when dealing with such a complication.</jats:p>
</jats:list-item>
</jats:list></jats:p>