Afghan percutaneous osteotomy.

An alternate technique to corticotomy for osteotomies to be used with external fixation is described. Percutaneous subperiosteal dissection is followed by passage of a Gigli saw and bone division. In contrast to corticotomy, the endosteum is divided, but the surrounding soft tissue envelope is less disrupted. In > 50 percutaneous Afghan osteotomies of the distal femur or proximal tibia, prompt healing has occurred in all cases, with no neurovascular complications. Two patients who had previously undergone corticotomy reported less pain after Afghan osteotomy. The technique is not applicable to the mid-femur because of the proximity of the profunda femoral artery.