Closing Cranial Wedge Ostectomy and Triple Tibial Osteotomy 245(A) (B)Figure 29.1 Closing cranial wedge ostectomy planning. (A) Lateral radiograph of the tibia of a dog with cranial cruciate
ligament rupture and a steep tibial slope. Lines depicting the functional axis of the tibia and the tibial plateau have been
positioned. The angle between these lines indicates a tibial plateau slope of 41◦. The planned wedge (42◦) is outlined on
the proximal metaphysis of the tibia. (B) The radiographic image has been ‘cut’ and the proximal portion rotated to
simulate the surgical correction. Note the cranial shift of the redrawn functional axis (compared to the original axis
position, indicated by the light gray line). The resulting tibial plateau slope is 5◦.
on concerns that it may lead to some shorten-
ing of the tibia and that, because it is a com-
plete osteotomy of the tibial shaft, it is poten-
tially more susceptible to failure of fixation than
a TPLO. It is, therefore, often reserved for situa-
tions where a TPLO may carry more risk. These
might include a steep TPA or small patient
size.