Adding a protective screw improves hinge's axial and torsional stability in High Tibial Osteotomy.

Backgrounds: Despite the use of a locking plate a 30% incidence of lateral hinge fracture after Open-Wedge High Tibial Ostetomy was described in the literature. A finite element model was used to analyze if the presence of a hinge-securing screw in the osteotomy area, using Patient Specific Cutting Guides with a locking plate, decreases the stresses within the lateral hinge during compression and torsion.

Methods: A 3D model of a tibial sawbone was used to simulate an opening wedge of 10°.