CORTICOTOMY

TECHNIQUES OF CORTICOTOMY

•METHODS• 1) PERCUTANEOUS

CORTICOTOMY

TECHNIQUES OF CORTICOTOMY

• 2) DRILLING OF POSTERIOR CORTEX

• 3) GIGLI SAW METHOD • 4) OBLIQUE OSTEOTOMY

PERCUTANEOUS CORTICOTOMY

•PRESERVES INTRAMEDULLARY AND ENDOSTEAL CIRCULATION

PERCUTANEOUS CORTICOTOMY

• 5-10 MM. INCISION OVER THE TIBIAL CREST

• LOW ENERGY OSTEOTOMY DONE USING OSTEOTOME AND HAMMER AFTER PERIOSTEAL ELEVATION

PERCUTANEOUS CORTICOTOMY

• FIRST ANTERIOR THEN MEDIAL AND LATERAL CORTICES CUT WITH OSTEOTOME

• SIMILARLY POSTEROMEDIAL AND POSTERO LATERAL CORNERS CUT

PERCUTANEOUS CORTICOTOMY

•OSTEOTOME TWISTED TO CUT POSTERIOR CORTEX

•COMPLETED BY ROTATIONAL OSTEOCLASIS

DRILLING OF POSTERIOR CORTEX

• ROTATIONAL OSTEOCLASIS DONE • POSTERIOR CORTEX PERFORATED

BY FOUR TO FIVE 4MM DRILL HOLES

GIGLI SAW METHOD

• SECOND INCISION MADE AT POSTEROMEDIAL BORDER

• PERIOSTEUM ELEVATED

GIGLI SAW METHOD • NEEDLE OR TAPE PASSED FROM POSTEROMEDIAL INCISION AROUND POST. CORTEX AND BROUGHT OUT THROUGH ANT. INCISION

• CUT BY GIGLI SAW

OBLIQUE OSTEOTOMY

• HAS SOME CORTICAL SUPPORT• DECREASES TENDENCY FOR

AXIAL DEVIATION• SPIRAL OSTEOTOMIES CAN

ALSO BE DONE