Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis

Category: Ankle Arthritis, Trauma Introduction/Purpose: The supination-adduction ankle fractures often showed vertical impaction of the tibial medial plafond. The malunion of these fractures cause the varus ankle deformity and secondary ankle arthritis. This retrospective control study looked at the use of supramalleolar osteotomy combined with intra-articular osteotomy in patients with malunited supination- adduction ankle fractures. Methods: Twelve patients were treated with malunited supination-adduction ankle fractures between January 2013 and December 2014. All of these patients had the varus ankle deformity and secondary ankle arthritis. Supramalleolar osteotomy combined with intra-articular osteotomy were underwent for the reconstruction surgery. The visual analog scale (VAS) score for pain during daily activities, Olerud and Molander Scale scores, subjective satisfaction survey rating and the modified Takakura classification stage were obtained. Ten patients were available for follow-up at a mean of 35.4 months (range, 28 to 40 months). Results: Average postoperative Olerud and Molander Scale score 24 months after surgery was 83±10 compared with 60±14 preoperatively. The mean VAS score decreased from 7±2 preoperatively to 2±2 at the latest follow-up. Six patients rated their result as excellent, 3 as good and 1 as fair. No significant difference in the modified Takakura classification stage was observed between the preoperative and the last follow-up. Conclusion: The use of supramalleolar osteotomy combined with intra-articular osteotomy was an effective option for the treatment of malunited supination-adduction ankle fractures.

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A cohort study of patients undergoing distal tibial osteotomy without fibular osteotomy for medial ankle arthritis with mortise widening

Fuß & Sprunggelenk ◽

10.1016/j.fuspru.2016.05.006 ◽

2016 ◽

Vol 14 (3) ◽

pp. 165-166

Keyword(s):

Cohort Study ◽

Tibial Osteotomy ◽

Ankle Arthritis ◽

Fibular Osteotomy

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Fibular osteotomy is helpful for talar reduction in the treatment of varus ankle osteoarthritis with supramalleolar osteotomy

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02732-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jing-Qi Liang ◽

Jun-Hu Wang ◽

Yan Zhang ◽

Xiao-Dong Wen ◽

Pei-Long Liu ◽

...

Keyword(s):

Range Of Motion ◽

Functional Evaluation ◽

Ankle Osteoarthritis ◽

Hindfoot Alignment ◽

Fibular Osteotomy ◽

Supramalleolar Osteotomy ◽

Significant Difference ◽

Functional Scores ◽

Talar Tilt ◽

Varus Ankle Osteoarthritis

Abstract Background There have been debates on the necessity of fibular osteotomy (FO) in supramalleolar osteotomy (SMOT) for the treatment of varus ankle osteoarthritis. The purpose of the current study was to compare the clinical and radiological outcomes between SMOT with and without FO in the treatment of varus ankle osteoarthritis. Methods The SMOT group included 39 patients, and the SMOT with FO group included 24 patients. The basic information reached no significant difference between groups. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Ankle Osteoarthritis Scale (AOS), modified Takakura stage and range of motion (ROM) were used for the functional evaluation. The radiologic parameters were assessed at the last follow-up to compare the degree of talar reduction between the two groups. Results Both groups achieved significant improvements in AOFAS scores, modified Takakura stage, as well as AOS pain and functional scores (P < 0.001). The ROM of the ankle joint in the SMOT group was significantly decreased (P = 0.022). In both groups, all of the radiological parameters were significantly improved (P < 0.01). The tibiofibular clear space (TFCS) was significantly widened in the SMOT group (P < 0.001). No significant difference was found between the two groups according to the functional outcomes. However, the talar tilt angle (TT) and hindfoot alignment angle (HFA) in the SMOT with FO group were significantly smaller than those in the SMOT group (P < 0.05). The TFCS was significantly widened in the SMOT group (P = 0.001). The medial displacement of the talus (MDT) was better reduced in the SMOT with FO group (P = 0.006). Conclusion SMOT is a promising procedure for functional improvement and malalignment correction in varus ankle osteoarthritis but reduces ankle range of motion. If SMOT is combined with FO, talar tilt and medial displacement will be better reduced.

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Supramalleolar Osteotomy and Ankle Arthrodiastasis for Juvenile Posttraumatic Ankle Arthritis

Clinics in Podiatric Medicine and Surgery ◽

10.1016/j.cpm.2014.08.001 ◽

2014 ◽

Vol 31 (4) ◽

pp. 597-601 ◽

Cited By ~ 3

Author(s):

John J. Stapleton ◽

Thomas Zgonis

Keyword(s):

Ankle Arthritis ◽

Supramalleolar Osteotomy

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Fibular osteotomy is helpful for talar reduction in the treatment of varus ankle osteoarthritis with supramalleolar osteotomy

10.21203/rs.3.rs-820783/v1 ◽

2021 ◽

Author(s):

Jing-Qi Liang ◽

Jun-Hu Wang ◽

Yan Zhang ◽

Xiao-Dong Wen ◽

Pei-Long Liu ◽

...

Keyword(s):

Range Of Motion ◽

Functional Evaluation ◽

Ankle Osteoarthritis ◽

Hindfoot Alignment ◽

Fibular Osteotomy ◽

Supramalleolar Osteotomy ◽

Significant Difference ◽

Functional Scores ◽

Talar Tilt ◽

Varus Ankle Osteoarthritis

Abstract Background There have been debates on the necessity of fibular osteotomy (FO) in supramalleolar osteotomy (SMOT) for the treatment of varus ankle osteoarthritis. The purpose of the current study was to compare the clinical and radiological outcomes between SMOT with and without FO in the treatment of varus ankle osteoarthritis. Methods The SMOT group included 39 patients, and the SMOT with FO group included 24 patients. The basic information reached no significant difference between groups. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Ankle Osteoarthritis Scale (AOS), modified Takakura stage and range of motion (ROM) were used for the functional evaluation. The radiologic parameters were assessed at the last follow-up to compare the degree of talar reduction between the two groups. Results Both groups achieved significant improvements in AOFAS scores, modified Takakura stage as well as AOS pain and functional scores (P༜0.001). The ROM of the ankle joint in the SMOT group was significantly decreased (P = 0.022). In both groups, all of the radiological parameters were significantly improved (P༜0.01). The tibiofibular clear space (TFCS) was significantly widened in the SMOT group (P༜0.001). No significant difference was found between the two groups according to the functional outcomes. However, the talar tilt angle (TT) and hindfoot alignment angle (HFA) in the SMOT with FO group were significantly smaller than those in the SMOT group (P༜0.05). The TFCS was significantly widened in the SMOT group (P = 0.001). The medial displacement of the talus (MDT) was better reduced in the SMOT with FO group (P = 0.006). Conclusion SMOT is a promising procedure for functional improvement and malalignment correction in varus ankle osteoarthritis but reduces ankle range of motion. If SMOT is combined with FO, talar tilt and medial displacement will be better reduced.

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Radiographic Outcomes of Proximal vs Distal Syndesmotic Low Tibial Osteotomy

Foot & Ankle International ◽

10.1177/10711007211035784 ◽

2021 ◽

pp. 107110072110357

Author(s):

Jun Young Choi ◽

Jin Ho Cho ◽

Tae Hun Song ◽

Jin Soo Suh

Keyword(s):

Tibial Osteotomy ◽

Ankle Arthritis ◽

Level Of Evidence ◽

Radiographic Findings ◽

Fibular Osteotomy ◽

Radiographic Outcomes ◽

Intermalleolar Distance ◽

Talar Tilt ◽

Retrospective Comparative Study ◽

Distance Correction

Background: We aimed to determine whether the location of tibial osteotomy affects the outcome during low tibial osteotomy (LTO) with fibular osteotomy for varus ankle arthritis by comparing proximal syndesmotic (PS) and distal syndesmotic (DS) tibial osteotomy. Methods: We retrospectively reviewed the radiographic findings of 50 cases (among 47 patients) who underwent LTO with fibular osteotomy for varus ankle arthritis. The enrolled patients were divided into 2 groups according to the location of the tibial osteotomy: the PS group (25 cases, 24 patients) and the DS group (25 cases, 23 patients). Radiographic parameters were compared between the 2 groups. Results: There were no significant differences in tibial anterior and lateral surface angles, tibiomedial malleolar angle, talar center migration, and intermalleolar distance correction between the 2 groups (all P > .05). However, the decreases in talar tilt (TT) and talocrural angle (TCA) were more pronounced in the DS group than in the PS group (both P < .05). Among patients with TT ≥8 degrees, a greater decrease in TT (+1.0 degrees vs –2.8 degrees) and TCA was observed in the DS group, whereas the PS group demonstrated greater increases in TCA and intermalleolar distance (all P < .01). Conclusion: In this series, DS tibial osteotomy combined with fibular osteotomy was a more effective operative option than PS tibial osteotomy to correct both extra- and intra-articular deformity for varus ankle arthritis. Level of evidence: Level III, retrospective comparative study.

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