Gigli Saw Osteotomy

This illustration describes the surgical procedure of using a gigli saw to perform an osteotomy (bone cut) in the upper end of the tibia (shin bone).

• A., B. Two small incisions are made just below the level of the tibial tubercle (a bony bump on the upper part of the shin).
• C., D. Then, using surgical tools called periosteal elevators, a subperiosteal tunnel is created around the tibia.
• E., F. Next, a tonsil clamp enters the lateral tunnel and an angle clamp, loaded with a heavy, braided suture, enters the medial tunnel. The surgeon will feel the two clamps touch each other.
• G., H. In the next step, the surgeon passes the braided suture from the angle clamp to the tonsil clamp.

• I., J., K. After the suture is pulled out with the tonsil clamp, the gigli saw is tied to the suture. The surgeon makes a slight bend on the edge of the gigli saw to allow it to pass more easily around the tibia.
• L. The gigli saw, tied to the suture, is then passed through the subperiosteal tunnel from the medial side of the tibia to the lateral side of the tibia.
• M., N. Periosteal elevators are placed behind the gigli saw to protect the surrounding tissue, and the osteotomy is completed with the gigli saw using a sawing motion.