Oblique osteotomy for tibial malunion (see text). A, Anterior and lateral views showing placement of Schanz pins parallel to planes of proximal and distal joints and to site of proposed osteotomy. B, Anterior view (left) after femoral distractor has been applied; rotational joint (a) is left open to allow lateral angular correction. Oblique osteotomy (b) is made to correct varus angulation and procurvatum; axial correction occurs as nut (c) is turned to lengthen distractor. Lateral view (right). Markings on distractor indicate angular correction has not been obtained. C, After angular correction is obtained, rotational joint is locked and further lengthening of distractor results in pure axial lengthening. Markings (right) now indicate that angular correction has been obtained. D, Anterior and lateral views after correction; lag screw has been inserted perpendicular to osteotomy. E, Final result with neutralization plate in place. (From Sanders R, Anglen JO, Mark JB: Oblique osteotomy for the correction of tibial malunion, J Bone Joint Surg 77A:240, 1995.) SEE TECHNIQUE 58.11.