CLOSED WEDGE OSTEOTOMY BY DRILLING LOWERS COMPLICATION RATE

Two techniques of closed wedge osteotomy of the proximal tibia in 132 cases using external fixation device were compared retrospectively for neurological complication rate. While in group 1 (n=89) wedge osteoto my was performed conventionally using an oscillating saw, in group 2 ( n=43) osteotomy was done with consecutive drill holes of increasing di ameter followed by osteoclasis. Neurological complications in group 1 were found postoperatively in 15.7% (transient) and after 7 months fol low-up time in 12.4% (persistent), in group 2 14% transient and 4.7% p ersistent neurological deficits were registered. The lower complicatio n rate in group 2 is due to the reduction of postoperative tibialis an terior syndrome (type B lesions). No differences for type C lesions (e xtension deficit of D1) were found. No complete peroneal palsy (type A ) ocurred in either group. The authors conclude that reduction of neur ological complications in group 2 is related to the less extensive app roach of the proposed technique.