2021 Annual Meeting Knee Access Pass-Performing an Opening Wedge Osteotomy, I See a Hinge Fracture: What Now?

Performing an Opening Wedge Osteotomy, I See a Hinge Fracture: What Now?

Video Transcription

Video Summary

Dr. Robbie presented on medial opening wedge osteotomies, emphasizing the critical role of the lateral hinge in biomechanical stability. Hinge fractures, often underdiagnosed on intraoperative X-rays but more visible on CT, can cause instability, loss of correction, and delayed healing. Classification into three types guides management, with prevention via proper hinge positioning, biplanar osteotomies, controlled opening gaps, and locking plate fixation. Treatment varies by fracture type; stable hinges allow faster rehab, while unstable fractures require delayed weight-bearing and possibly additional fixation. Cases highlighted challenges and solutions, stressing prevention, careful technique, and patient-specific factors like bone health and correction size.

Asset Caption

Dr. Robert Duerr

Keywords

medial opening wedge osteotomy

lateral hinge

hinge fractures

biomechanical stability

osteotomy fixation