Evaluation of the Fibula after High Tibial Ostetomy: Status of Bone Union of the Fibula and Clinical Symptoms.:Status of Bone Union of the Fibula and Clinical Symptoms

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Clinical and radiographic examinations of fibular osteotomy sites were performed on one hundred knees in 68 patients who underwent high tibial osteotomy. An average follow-up period was 4 years and 10 months.Nonunions of the fibula were seen in 21 knees. Hypertrophic nonunions were seen in 15 knees and atrophic nonunions in 6 knees.The group of patients who had nonunions of the fibula showed higher rate of positive symptoms in gait pain and tenderness at the fibular osteotomy sites than those who had unions. The group of patients who underwent the ostrotomy of the fibula at its middle one third showed higher rate of positive symptoms than those who underwent osteotomy at its proximal one third of the fibula. Most patients who developed symptoms at the fibular osteotomy sites had hypertrophic nonunions. No patients who developed symptoms had atrophic nonunions.Our latest technique of the high tibial osteotomy includes bone chip graft to the fibular osteotomy sites to promote bone unions of the fibula.