Fig. 5From: Effect of lateral hinge fractures for bone union and clinical outcomes following opening-wedge distal tibial tubercle osteotomy in comparison with opening-wedge high tibial osteotomyMechanism leading to a delayed union at the anterior flange. The anterior flange is compressed by the patellar tendon during knee flexion following OWHTO. By comparison, the anterior flange is pulled apart by the patellar tendon during knee motion after OWDTO. A lateral hinge fracture (LHF) causes greater instability, especially with OWDTO. OWDTO, opening-wedge distal tubercle osteotomy; OWHTO, opening-wedge high tibial osteotomyBack to article page