Aim: Pure torsional deformities of the tibia can be treated with either a proximal or distal tibial osteotomy. It is noted that the relative advantages of these osteotomies are controversial and maybe influenced by other factors. A retrospective study was undertaken to assess the two methods.

Materials and Methods: Between 1997 and 2003, a retrospective study of 48 osteotomies was undertaken. Clinical records and X-rays were reviewed. There were 27 proximal osteotomies and 21 distal osteotomies. 24 were stabilised with plate fixation and 23 with percutaneous wires. The osteotomies were not matched with variables in age, site and fixation type. The sex distribution was similar. The majority of proximal osteotomies were fixed with a plate and distal osteotomies with pins.

Results: There were 2 cases of proximal osteotomy which developed a non-union. In general however, the time to radiological union in the two groups was similar.

Conclusion: It was felt that distal osteotomies were technically easier and therefore should be advocated. As in previous literature reviews, there is an increased risk of neuro-vascular complications in proximal osteotomies.