Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of bone
Background: Hinge fracture on the lateral part of the tibia (LHF) is a common complication of medial Open Wedge High Tibial Osteotomy (OWHTO). Many factors have been described as risks for these fractures, but no study has compared an osteotome or an oscillating saw to prevent LHF following OWHTO. M...
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EDP Sciences
2025-01-01
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| author | Bastard Claire Haiat Guillaume Hernigou Philippe |
| author_facet | Bastard Claire Haiat Guillaume Hernigou Philippe |
| author_sort | Bastard Claire |
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| description | Background: Hinge fracture on the lateral part of the tibia (LHF) is a common complication of medial Open Wedge High Tibial Osteotomy (OWHTO). Many factors have been described as risks for these fractures, but no study has compared an osteotome or an oscillating saw to prevent LHF following OWHTO. Methods: This “propensity-score-matched” (PSM) study was conducted from data obtained in the literature from 1974 to November 2024. A total of 10,368 knees with OWHTO were identified. After 1:1 matching based on correction amount, posterior slope change, surgeon’s experience, the osteotome and oscillating groups comprised 2760 knees each. Results: Among the 5520 knees of the PSM population, the prevalence of LHF was 6.1% in the osteotome alone group (168 cases), and 22% in the oscillating saw group (607 cases). The osteotome group had a significant lower prevalence of hinge fracture than the oscillating saw group (OR, 0.23; 95% CI, 0.19 to 0.27; p < 0.0001) and a lower rate of clinically relevant hinge fractures with revision (OR, 0.34; 95% CI, 0.25 to 0.45; p < 0.001. Discussion: The osteotome may be an appropriate method for preventing hinge fractures following OWHTO. |
| format | Article |
| id | doaj-art-3b45a76fcb3c43e08cc4d065cca54585 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | EDP Sciences |
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| series | SICOT-J |
| spelling | doaj-art-3b45a76fcb3c43e08cc4d065cca545852025-02-07T08:31:26ZengEDP SciencesSICOT-J2426-88872025-01-0111510.1051/sicotj/2024060sicotj240133Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of boneBastard Claire0Haiat Guillaume1Hernigou Philippe2Hôpital Saint-AntoineCNRS, Université Gustave Eiffel, University Paris East (UPEC)Hospital Henri Mondor, University Paris East (UPEC)Background: Hinge fracture on the lateral part of the tibia (LHF) is a common complication of medial Open Wedge High Tibial Osteotomy (OWHTO). Many factors have been described as risks for these fractures, but no study has compared an osteotome or an oscillating saw to prevent LHF following OWHTO. Methods: This “propensity-score-matched” (PSM) study was conducted from data obtained in the literature from 1974 to November 2024. A total of 10,368 knees with OWHTO were identified. After 1:1 matching based on correction amount, posterior slope change, surgeon’s experience, the osteotome and oscillating groups comprised 2760 knees each. Results: Among the 5520 knees of the PSM population, the prevalence of LHF was 6.1% in the osteotome alone group (168 cases), and 22% in the oscillating saw group (607 cases). The osteotome group had a significant lower prevalence of hinge fracture than the oscillating saw group (OR, 0.23; 95% CI, 0.19 to 0.27; p < 0.0001) and a lower rate of clinically relevant hinge fractures with revision (OR, 0.34; 95% CI, 0.25 to 0.45; p < 0.001. Discussion: The osteotome may be an appropriate method for preventing hinge fractures following OWHTO.https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj240133/sicotj240133.htmlhigh tibial osteotomyopen wedgeopening wedgehinge fractureosteotomeoscillating sawimpact-based analysis methodinstrumented hammerpiezoelectric force sensor |
| spellingShingle | Bastard Claire Haiat Guillaume Hernigou Philippe Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of bone SICOT-J high tibial osteotomy open wedge opening wedge hinge fracture osteotome oscillating saw impact-based analysis method instrumented hammer piezoelectric force sensor |
| title | Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of bone |
| title_full | Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of bone |
| title_fullStr | Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of bone |
| title_full_unstemmed | Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of bone |
| title_short | Revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review: the oscillating saw cannot replace the traditional “ear-hand” dialogue between osteotome and hammer to estimate the elastic modulus of bone |
| title_sort | revisiting two thousand hinge fractures in open wedge high tibial osteotomy with a fifty years review the oscillating saw cannot replace the traditional ear hand dialogue between osteotome and hammer to estimate the elastic modulus of bone |
| topic | high tibial osteotomy open wedge opening wedge hinge fracture osteotome oscillating saw impact-based analysis method instrumented hammer piezoelectric force sensor |
| url | https://www.sicot-j.org/articles/sicotj/full_html/2025/01/sicotj240133/sicotj240133.html |
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