Finite Element Analysis of Protective Measures against Lateral Hinge Fractures in High-Tibial Osteotomy.

The findings suggest that a 4.5 mm drill hole may be more effective in reducing the risk of LHFs compared to thinner diameter K-wires or smaller apical holes. Both a 2.5 mm K-wire and a 4.5 mm drill hole reduce the number of cracked elements, but the 4.5 mm drill hole also significantly decreases the average and maximum principal stresses as well as the average tensile strength ratio at the hinge area. These findings may be important for surgical planning, particularly in cases requiring increased osteotomy distraction.