A report of nonunion at medial wedge high tibial osteotomy site and its management.

High tibial osteotomy (HTO) is an accepted treatment option for correcting deformities and reducing pain in the treatment of uni-compartment osteoarthritis of the knee. The principle is to redistribute the weight-bearing load. Medial open wedge HTO (MOWHTO) has gained popularity over lateral closed wedge osteotomy due to its decreased incidence of complications. MOWHTO surgical techniques have many variations in fixation techniques and in the use of bone grafts or bone substitute augmentation. In spite of the existing guidelines, there are no clear indications of grafting at the osteotomy site. Delayed union and nonunion although are possible complications, nonunion is especially rarely reported. Thus authors in this case report, like to point attention towards this under-reported complication and its management.