PURPOSE: Oblique proximal tibial osteotomy is a useful option for correcting 
deformity associated with Blount's disease (tibia vara). Safe, adequate 
correction depends on technical issues that have evolved since the original 
description of the procedure.
METHODS: Retrospective review of surgical experience.
RESULTS: The refinement of osteotomy plane orientation, based on the distal 
rather than the proximal tibia, reduces the likelihood of procurvatum after 
surgery. The stability of the osteotomy is enhanced by an improved screw 
fixation technique. The risk of compartment syndrome is low if prophylactic 
partial fasciotomy is performed concurrently. Avoidance of spinal or regional 
block anesthesia minimizes the possibility of failure to detect post-operative 
compartment syndrome.
CONCLUSIONS: Improvements in the technical execution of oblique proximal tibial 
osteotomy enhances the correction and predictability of the procedure.