The document discusses different techniques for performing a corticotomy, including the classic percutaneous corticotomy method, the Gigli saw method, and oblique osteotomy. The percutaneous corticotomy involves making small incisions over the tibial crest and using an osteotome with hammer to cut the anterior, medial, lateral, posteromedial, and posterolateral cortices while preserving the intramedullary and endosteal circulation. The Gigli saw method involves a second incision to pass a needle or tape around the posterior cortex to be cut with a Gigli saw. An oblique osteotomy provides some cortical support and decreases the tendency for axial deviation compared to other techniques.

1. THE ILIZAROV
CORTICOTOMY
DR. AHMED ABDEL-GHANI
M.SC. - M.R.C.S. - C.P.H.Q.

2. INTRODUCTION:
• CLASSIC CORTICOTOMY IS A
PERCUTANEOUS , SUBPERIOSTEAL
CORTICAL OSTEOTOMY.
• IMPORTANT FACTORS:
1- CONFIGURATION
2- SURGICAL EXPOSURE
3- ENERGY USED

3. TECHNIQUES OF
CORTICOTOMY
•METHODS
• 1) PERCUTANEOUS
CORTICOTOMY( CLASSIC
METHOD)

4. TECHNIQUES OF
CORTICOTOMY
2) GIGLI SAW METHOD
3) OBLIQUE OSTEOTOMY

5. PERCUTANEOUS
CORTICOTOMY
• PRESERVES
INTRAMEDULLARY AND
ENDOSTEAL CIRCULATION

6. PERCUTANEOUS
CORTICOTOMY
• 5-10 MM. INCISION OVER THE
TIBIAL CREST
• LOW ENERGY OSTEOTOMY
DONE USING OSTEOTOME AND
HAMMER AFTER PERIOSTEAL
ELEVATION

7. PERCUTANEOUS
CORTICOTOMY
• FIRST ANTERIOR THEN MEDIAL
AND LATERAL CORTICES CUT
WITH OSTEOTOME
• SIMILARLY POSTEROMEDIAL
AND POSTERO LATERAL
CORNERS CUT

8. PERCUTANEOUS
CORTICOTOMY
• OSTEOTOME TWISTED TO
CUT POSTERIOR CORTEX
• COMPLETED BY ROTATIONAL
OSTEOCLASIS

13. GIGLI SAW METHOD
• SECOND INCISION MADE AT
POSTEROMEDIAL BORDER
• PERIOSTEUM ELEVATED

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

17. OBLIQUE OSTEOTOMY
• HAS SOME CORTICAL SUPPORT
• DECREASES TENDENCY FOR
AXIAL DEVIATION

18. Conclusion:
 MINIMALLY DISSECT SOFT TISSUES
• DO NOT CUT PERIOSTEUM
TRANSVERSELY
• DO NOT USE HIGH ENERGY IN
MAKING THE OSTEOTOMY.