& BULL; Lateral hinge fractures (LHF) are one of the most common complications of medial opening wedge high tibial osteotomy (MOWHTO), and are the leading cause of construct instability displacement, non-union, and varus recurrence after this procedure.& BULL; To date, Takeuchi's classification is the most popular classification to describe this complication, and it can help surgeons to make intra and postoperative decisions.& BULL; Opening medial gap width is the most recognized factor related to LHF occurrence.& BULL; Recognizing the implications of LHF in patients' clinical and radiographic results has led many authors to propose surgical tips and the use of osteosynthesis materials such as K-wires and screws for its prevention, which should be considered when identifying risk factors for LHF during preoperative planning.& BULL; The evidence for determining the optimal management of LHF is scarce and mostly supported by experts' opinions and recommendations; therefore, studies are still needed to identify the most appropriate behavior when dealing with such a complication.