Arthroscopic fixation of humeral greater tuberosity fracture using a W-shaped suture

Abstract Background Patients with greater tuberosity fractures of the humerus often require surgery. Therefore, there is a need to find a minimally invasive and effective surgical procedure with great patient outcomes. Aim To evaluate the clinical outcomes of the W-shaped suture technique under shoulder arthroscopy in the treatment of greater tuberosity fractures of the humerus. Methods In this retrospective study, a total of 17 patients were included. The fractures were closed, and there was no neurovascular injury. These patients underwent arthroscopically assisted reduction and internal fixation of the greater tuberosity fractures. Fixation was performed using sighting nails combined with a W-shaped suture. The imaging data of the patients were collected, and the ASES score, Constant-Murley score, and VAS score were used to evaluate the patient’s outcome. At the last follow-up (at least 1 year), the range of motion in the affected shoulder was compared with that of the contralateral side. Results The operation was successful in all the patients. The average follow-up time was 13 months. There were no reported complications such as fracture displacement, nonunion, and internal fixation failure during the follow-up period. Post-operative X-ray examinations revealed good function recovery, with a healing time of between 10 and 12 weeks, and an average healing time of 11.5 weeks. Following the operation, patients reported reduced shoulder joint pain that no longer influenced their activity or caused discomfort in their daily life. The patient’s VAS score ranged from 0 to 3, with an average of 0.52 ± 0.73, while at the last follow-up, the Constant-Murley score ranged from 83 to 97, with an average of 92.33 ± 7.55. The ASES score ranged from 81 to 98, with an average of 93.15 ± 6.93. At the last follow-up, there was no significant difference in the overall range of motion with the unaffected limb. Conclusion This study demonstrates that the W-shaped suture can be used to effectively fix the fractures of the greater tuberosity of the humerus, by increasing the fixed area to promote healing.

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Arthroscopic fixation of humeral greater tuberosity fracture with W-shaped suture

10.21203/rs.3.rs-46125/v1 ◽

2020 ◽

Author(s):

Xiaocong Lin ◽

Kaibin Fang ◽

Qingfeng Ke ◽

Wenhua Wu ◽

Shaojian Shi ◽

...

Keyword(s):

Internal Fixation ◽

Range Of Motion ◽

Shoulder Joint ◽

Joint Pain ◽

Shoulder Arthroscopy ◽

Greater Tuberosity ◽

Greater Tuberosity Fracture ◽

Vas Score ◽

Significant Difference

Abstract Background Patients with a greater tuberosity fracture of the humerus often require surgery. Finding a less invasive and more effective way of doing surgery could help patients better. Aim To evaluate the clinical value of w-shaped suture technique under shoulder arthroscopy in the treatment of humerus greater tuberosity fractures. Methods A total of 17 patients were included in the study. These fractures are closed, and there is no neurovascular injury. These patients underwent arthroscopically assisted reduction and internal fixation. Fixation was done by means of sighting nails combined with W - shaped suture. The imaging data of the patients were collected. ASES score, Constant-Murley score and VAS score were used to evaluate the efficacy of patients. At the last follow-up (at least one year), the range of motion of the affected and contralateral shoulder joints was compared. Results All patients completed the operation successfully. The average follow-up time was 13 months. No complications such as fracture displacement, nonunion and internal fixation failure occurred during the follow-up period. According to the X-ray examination of the patients, we found that all the fractures healed smoothly, the healing time was 10–12 weeks, with an average of 11.5 weeks. After the operation, the patients complained that the shoulder joint pain was obviously relieved, and there was no influence on the activity due to shoulder joint pain and discomfort in daily life. The VAS score of these patients ranged from 0 to 3, with an average of 0.52 ± 0.73. At the last follow-up, the constant murlev score of these patients ranged from 83 to 97, with an average of 92.33 ± 7.55. The ases score of these patients ranged from 81 to 98, with an average of 93.15 ± 6.93. At the last follow-up, there was no significant difference in the range of motion of the unaffected limb。 Conclusion This study demonstrates that technique of W-shaped suture can effectively fix the fracture of greater tuberosity of humerus. This technique can disperse the shear force and torsion force of suture, and increase the fixed area to promote healing, which is an effective treatment method.

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Comparison between buttress plate and anteroposterior screw internal fixation for posterior pilon fracture: a retrospective study

10.21203/rs.3.rs-18058/v2 ◽

2020 ◽

Author(s):

linyuan zhang ◽

zhiqing liu ◽

yueting wang ◽

chao yu ◽

jian tang ◽

...

Keyword(s):

Surgical Treatment ◽

Internal Fixation ◽

Ankle Joint ◽

Joint Pain ◽

Healing Time ◽

Pilon Fracture ◽

Significant Difference ◽

Vas Scores ◽

Buttress Plate

Abstract Background: Posterior pilon fracture (PPF) is a serious ankle injury caused by combined vertical and rotational trauma. Surgical treatment includes buttress plate (BP), anteroposterior screw (APS) and posteroanterior screw (PAS) fixation. This study aimed to compare the therapeutic effects after PPF internal fixation with BPs and APSs. Methods: From January 2015 to June 2018, 37 patients with PPFs underwent surgical treatment in our institution. The patients were divided into the BP (11 patients) and APS (26 patients) groups according to the internal fixation method. Bone healing time and postoperative complications were recorded. At the last follow-up, American Orthopedic Foot and Ankle Society (AOFAS) scores, visual analog scale (VAS) scores and Burwell-Charnley scores were used to evaluate ankle joint function, ankle joint pain, and fracture reduction on imaging, respectively. Results: No significant difference in bone healing time was found between the two groups (P > 0.05). Local necrosis of the posterolateral incision and chronic ankle pain occurred in 1 case each in the BP group. Chronic ankle joint pain occurred in 4 cases in the APS group. Two cases of soft tissue irritation were caused by screws that were too long. Local numbness of the posterolateral incision occurred in 1 case. At the last follow-up, no significant difference in VAS scores between the two groups at rest (P = 0.477), but a significant difference during exercise was noted (P = 0.033). AOFAS scores were better in the BP group than those in the APS group (P = 0.002). According to the Burwell-Charnley scoring system, 11 cases were anatomically reduced in the BP group. In the APS group, anatomical reduction was achieved in 19 cases and fair in 7 cases. Conclusion: Compared with APSs, BPs resulted in better reduction, ankle joint functional recovery and complication rates. BPs are recommended for internal fixation of PPFs.

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Comparison between buttress plate and anteroposterior screw internal fixation for posterior pilon fracture: a retrospective study

10.21203/rs.3.rs-18058/v1 ◽

2020 ◽

Author(s):

linyuan zhang ◽

zhiqing liu ◽

yueting wang ◽

chao yu ◽

jian tang ◽

...

Keyword(s):

Surgical Treatment ◽

Internal Fixation ◽

Ankle Joint ◽

Joint Pain ◽

Healing Time ◽

Pilon Fracture ◽

Significant Difference ◽

Vas Scores ◽

Buttress Plate

Abstract Background Posterior pilon fracture (PPF) is a serious ankle injury caused by combined vertical and rotational trauma. Surgical treatment includes buttress plate (BP), anteroposterior screw (APS) and posteroanterior screw (PAS) fixation. This study aimed to compare the therapeutic effects after PPF internal fixation with BPs and APSs. Methods From January 2015 to June 2018, 37 patients with PPFs underwent surgical treatment in our institution. The patients were divided into the BP (11 patients) and APS (26 patients) groups according to the internal fixation method. Bone healing time and postoperative complications were recorded. At the last follow-up, American Orthopedic Foot and Ankle Society (AOFAS) scores, visual analog scale (VAS) scores and Burwell-Charnley scores were used to evaluate ankle joint function, ankle joint pain, and fracture reduction on imaging, respectively. Results No significant difference in bone healing time was found between the two groups ( P > 0.05). Local necrosis of the posterolateral incision and chronic ankle pain occurred in 1 case each in the BP group. Chronic ankle joint pain occurred in 4 cases in the APS group. Two cases of soft tissue irritation were caused by screws that were too long. Local numbness of the posterolateral incision occurred in 1 case. At the last follow-up, no significant difference in VAS scores between the two groups at rest ( P = 0.477), but a significant difference during exercise was noted ( P = 0.033). AOFAS scores were better in the BP group than those in the APS group ( P = 0.002). According to the Burwell-Charnley scoring system, 11 cases were anatomically reduced in the BP group. In the APS group, anatomical reduction was achieved in 19 cases and fair in 7 cases. Conclusion Compared with APSs, BPs resulted in better reduction, ankle joint functional recovery and complication rates. BPs are recommended for internal fixation of PPFs.

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Revision Rates After Surgical Treatment for Femoral Neck Fractures: Results of 2-Year Follow-up

Medicina ◽

10.3390/medicina49030022 ◽

2013 ◽

Vol 49 (3) ◽

pp. 22

Author(s):

Jaunius Kurtinaitis ◽

Narūnas Porvaneckas ◽

Giedrius Kvederas ◽

Tomas Butėnas ◽

Valentinas Uvarovas

Keyword(s):

Total Hip Arthroplasty ◽

Femoral Neck ◽

Internal Fixation ◽

Hip Arthroplasty ◽

Revision Surgery ◽

Femoral Neck Fractures ◽

Total Hip ◽

Significant Difference ◽

Surgery Rates

Background and Objective. Intracapsular fractures of the femoral neck account for a major share of fractures in the elderly. Open reduction and internal fixation has been shown to have a higher rate of revision surgery than arthroplasty. The aim of this study was to assess and compare the rates of revision surgery performed after internal fixation and primary total hip arthroplasty. Material and Methods. Between 2004 and 2006, 681 intracapsular femoral neck fractures in 679 consecutive patients were treated with internal fixation or total hip arthroplasty at our institution. Revision surgery rates were evaluated at 1-, 3-, 6-, 12-, and 24-month follow-up. Results. There was no significant difference in the ratio of internal fixation to total hip arthroplasty during 2004–2006 (P=0.31). The mean rate of total hip arthroplasty was 19.1% with a lower rate being among patients younger than 60 years. Revision surgery rates at the 2-year followup were higher in the internal fixation group compared with total hip arthroplasty group (28.9% vs. 7.0%, P<0.001). Patients who underwent internal fixation were at a 4-fold greater risk of having revision surgery at the 2-year follow-up than those who underwent total hip arthroplasty (odds ratio, 4.11; 95% CI, 1.95–8.65; P<0.001). Age was a significant risk factor for revision surgery after total hip arthroplasty (hazard ratio, 0.93; 95% CI, 0.87–0.98; P=0.02), but not significant after the internal fixation (P=0.86). Conclusions. Higher revision surgery rates after internal fixation favors arthroplasty as a primary choice of treatment for the femoral neck fractures.

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Clinical Significance of PLIF in Restoring L4-S1 Segmental Lordosis of 2-level Isthmic Spondylolisthesis

10.21203/rs.3.rs-198135/v1 ◽

2021 ◽

Author(s):

Jing-Yu Wang ◽

Fu-Sheng Liu ◽

Jing Li ◽

Xiao-Bin Wang

Keyword(s):

Sagittal Plane ◽

Pearson Correlation ◽

Isthmic Spondylolisthesis ◽

Improvement Rate ◽

Clinical Prognosis ◽

Vas Score ◽

Score Improvement ◽

Significant Difference ◽

Sagittal Parameters

Abstract Background: Spinal and pelvic sagittal plane balance is closely related to good clinical prognosis, so in the treatment of 2-level isthmic spondylolisthesis, attention should be paid not only to adequate nerve decompression, but also to the correction of lumbosacral sagittal plane parameters. The purpose of this study was to observe the clinical prognosis and sagittal parameters of patients with isthmic spondylolisthesis treated with PLIF, and to find out the risk factors leading to poor prognosis. Methods: From January 2006 to August 2018, the clinical data of patients with 2-level isthmic spondylolisthesis treated with PLIF in the Second Xiangya Hospital of Central South University were retrospectively collected. The clinical symptoms (JOA score and VAS score) and the sagittal parameters of lumbosacral segment (PI, PT, LL, L4-S1 SL, LDI, PI-LL, LL and L4-S1 SL) were recorded before operation, immediately after operation and at the last follow-up. According to the improvement rate of JOA score, the patients were divided into two subgroups, poor(P) group and good(G) group. The parameters within and between the two subgroups were compared. Meanwhile, Pearson correlation analysis was conducted between sagittal parameters and JOA score improvement rate.Results: A total of 52 patients were enrolled in this study, the average age was (59.96 ±9.11) years, and the mean follow-up time was (31.88 ±8.37) months. Group G (n = 37) and group P (n = 15). In terms of clinical symptom improvement and sagittal plane parameters, except PI, the other parameters of the patients were improved compared with those before operation, and the difference was statistically significant. In the intra-group comparison, except PI, other indexes in group G were significantly improved, while in group P, there was no significant difference in PI, LL, L4-S1 SL, LDI, PI-LL before and after operation. In the comparison between groups, there was no significant difference in baseline data between group G and group P; postoperative VAS score(back pain) in group G was lower than that in group P, but there was no significant difference in VAS score( leg pain); in terms of JOA score and JOA score improvement rate, group G was significantly better; △L4-S1 SL ,L4-S1 SL and LDI were larger in group G, and the proportion of patients with normal LDI was higher than that in group P. Pearson correlation analysis showed that postoperative △L4-S1 SL, LDI and L4-S1 SL were positively correlated with JOA improvement rate. 2 patients with failed internal fixation occurred in group P, and the postoperative LDI was less than 50%. Conclusion: PLIF is an effective method for the treatment of 2-level isthmic spondylolisthesis. ΔL4-S1 SL, L4-S1 SL and good LDI may be important sagittal parameters affecting the clinical prognosis of L4 and L5 isthmus spondylolisthesis.

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Surface Replacement Proximal Interphalangeal Joint Arthroplasty: A Case Series

Hand ◽

10.1177/1558944718760035 ◽

2018 ◽

Vol 14 (5) ◽

pp. 669-674

Author(s):

Pieter W. Jordaan ◽

Duncan McGuire ◽

Michael W. Solomons

Keyword(s):

Patient Satisfaction ◽

Range Of Motion ◽

Retrospective Review ◽

Case Series ◽

Proximal Interphalangeal Joint ◽

Joint Arthroplasty ◽

Interphalangeal Joint ◽

Surface Replacement ◽

Significant Difference

Background: In 2012, our unit published our experience with a pyrocarbon proximal interphalangeal joint (PIPJ) implant. Due to high subsidence rates, a decision was made to change to a cemented surface replacement proximal interphalangeal joint (SR-PIPJ) implant. The purpose of this study was to assess whether the change to a cemented implant would improve the subsidence rates. Methods: Retrospective review of all patients who had a cemented SR-PIPJ arthroplasty performed from 2011 to 2013 with at least 12 months follow-up. Results: A total of 43 joints were included with an average follow-up of 26.5 months. There was a significant ( P = .02) improvement in arc of motion with an average satisfaction score of 3.3 (satisfied patient). Subsidence was noted in 26% of joints with a significant difference in range of motion ( P = .003) and patient satisfaction ( P = .001) between the group with and without subsidence. Conclusions: The change to a cemented implant resulted in satisfied patients with an improvement in range of motion. The rate of subsidence improved but remains unacceptably high.

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Shoulder girdle impairment in breast cancer survivors: the role of range of motion as predictive factor for dose distribution and clinical outcome

Tumori Journal ◽

10.1177/0300891619839287 ◽

2019 ◽

Vol 105 (4) ◽

pp. 319-330 ◽

Cited By ~ 4

Author(s):

Fabio Marazzi ◽

Valeria Masiello ◽

Domenico Marchesano ◽

Luca Boldrini ◽

Stefano Luzi ◽

...

Keyword(s):

Breast Cancer ◽

Range Of Motion ◽

Functional Impairment ◽

Predictive Factor ◽

Late Complication ◽

Shoulder Girdle ◽

Dash Score ◽

Observational Analysis ◽

Significant Difference

Background:Pain and functional impairment of the ipsilateral shoulder girdle in patients who underwent surgery and radiotherapy for breast cancer (BC) is a late complication reported in the literature. We analyze a correlation with dosimetric parameters and propose an algorithm for sparing strategies.Methods:A total of 111 patients treated for BC were included in this observational analysis during follow-up protocol visits. Exclusion criteria were the presence of moderate or severe arthrosis history and/or rheumatologic diseases. All the patients had complete physical and multidimensional examinations during joint (physiatrist and radiotherapy oncology) follow-up visits. A scapula–humeral articulation (SHA) standardized contouring was performed retrospectively on Eclipse® treatment plans. A possible correlation between patients’ characteristics, radiotherapy, and dosimetry analysis and functional impairment was investigated at statistical analysis. Results of analysis were summarized into a proposal of algorithm for sparing SHA.Results:A total of 111 patients were selected during follow-up visits. Mean age of patients was 60 years (range 41–85 years). A total of 103 patients (93%) underwent conservative surgery, with 110 patients (99%) undergoing axilla surgery as well. Fifty-two patients (46.8%) presented a reduction of range of motion (ROM) abduction on the treated side at the observational analysis. Mean ROM abduction reduction was 13°06’ (range 0°–100°). Disability of the Arm, Shoulder and Hand questionnaire (DASH) score results were excellent in 79 patients (71.2%), discrete in 15 patients (13.5%), good in 15 patients (13.5%), and sufficient in 2 patients (1.8%). Median EQD2Dmaxat SHA was 18 Gy (range 0.22–51.9 Gy) and median EQD2mean dose at SHA was 2 Gy (range 0.04–24.32 Gy). Univariate analysis showed a linear correlation between DASH score and ROM of abduction of treated side (ρ=−0.7), ROM of abduction and ROM of flexion in ipsilateral arm (ρ=0.8), or ROM of abduction and ROM of flexion in contralateral arm (ρ=0.8). A statistically significant difference in ROM abduction between the 2 arms was found at χ2test ( P<0.05 at χ2confidence interval = 95%). Cox linear regression analysis showed ROM abduction on treated arm as a predictive factor of DASH score ( P<0.0001). Age ( P<0.05), DASH score ( P=0.006), and ROM abduction on treated arm ( P=0.005) were found as independent predictive factors of mean dose at multivariate analysis. A mean dose higher than 7 Gy and ROM abduction reduction more than 30° were related to DASH score level reduction.Conclusions:This hypothesis-generating study introduces an algorithm to be validated for management of sparing SHA and improving quality of survivorship. ROM evaluation after surgery, early physiotherapy, standard contouring, and planning adaptation represent possible indications to preserve shoulder impairment. Further prospective studies are needed to discriminate impairment of surgery and radiotherapy in order to personalized therapeutic plan programs.

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Comparison Of Medial Arch-Supporting Insoles And Heel Pads In The Treatment Of Plantar Fasciitis

Serbian Journal of Experimental and Clinical Research ◽

10.1515/sjecr-2015-0006 ◽

2015 ◽

Vol 16 (1) ◽

pp. 39-42 ◽

Cited By ~ 2

Author(s):

Melih Malkoc ◽

Ozgur Korkmaz ◽

Adnan Kara ◽

Ismail Oltulu ◽

Ferhat Say

Keyword(s):

Daily Activity ◽

Plantar Fasciitis ◽

Plantar Fascia ◽

Clinical Results ◽

Activity Score ◽

Vas Score ◽

Sporting Activity ◽

Significant Difference ◽

The Mean

ABSTRACTPlantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles.We retrospectively reviewed 75 patients with heel pain. A total of 35 patients in the first group were treated with medial arch supporting insoles, and 40 patients in the second group were treated with heel pads. The patients were evaluated with the Visual Analogue Scale (VAS) and the Foot and Ankle Ability Measure (FAAM) at the first and last examinations.The mean VAS score in the first group was 8.6±1,2 (6-10); the FAAM daily activity score was 66.2±16 (41.2-95.0), and the sporting activity score was 45.4±24,4 (0.1-81) before treatment. At the last follow-up in this group, the mean VAS score was 5.3±1,5 (0-9); the FAAM daily activity score was 83,0±15,1 (55,9-100), and the sporting activity score was 73,5±26,2 (25-100). The mean VAS score in the second group was 8,6±0,9 (7-10); the FAAM daily activity score was 66.4±17 (41.4-95.2), and the sporting activity score was 45.8±24,2 (0.8-81, 3) before the treatment. At the last follow-up in this group, the mean VAS score was 5.5±1,2 (0-9); the FAAM daily activity score was 83.4±14,9 (60, 2-100), and the sporting activity score was 73.8±26 (28-100).There was no significant difference in the clinical results of both groups. The force distribution by the use of silicone heel pads and medial arch-supported silicone insoles had no effect on the clinical results of the treatment of plantar fasciitis.

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Comparison of the efficacy of MIS-TLIF combined with unilateral or bilateral internal fixation on single-segment lumbar degenerative diseases

European Journal of Inflammation ◽

10.1177/2058739219844393 ◽

2019 ◽

Vol 17 ◽

pp. 205873921984439

Author(s):

Lisheng Zhao ◽

Huijin Yu ◽

Yan Zhang ◽

Wenjun Zhen

Keyword(s):

Internal Fixation ◽

Lumbar Lordosis ◽

Clinical Effects ◽

Degenerative Diseases ◽

Single Segment ◽

Tnf Α ◽

Significant Difference ◽

Lumbar Degenerative Diseases ◽

Serum Crp

In this study, to compare the efficacy of minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) combined with unilateral or bilateral internal fixation for the treatment of single-segment lumbar degenerative diseases, patients with single-segment lumbar degenerative diseases treated with MIS-TLIF combined with unilateral or bilateral internal fixation in Rehabilitation Center, Gansu Province Hospital from January 2014 to November 2015 were retrospectively enrolled, and the related data of 85 patients with 2-year follow-up were obtained. The patients were divided into unilateral group (40 cases) and bilateral group (45 cases) according to the method of internal fixation, and the Oswestry dysfunction index (ODI), visual analogue scale (VAS), lumbar lordosis angle, surgical segmental lordosis angle, lumbar scoliosis angle, surgical segmental scoliosis angle, lumbar lordosis index (LI), intervertebral height index (IHI), fusion rates, and serum inflammatory factors, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor alpha (TNF-α), were calculated to evaluate the efficacy of these two surgical methods. The results showed that the VAS and ODI of the two groups at 1 month, 6 months after surgery, and the last follow-up were significantly improved when compared with those before surgery ( P < 0.05). However, there were no significant differences in VAS and ODI between the two groups at preoperative, 1 month, 6 months after surgery, and the last follow-up ( P > 0.05). The lumbar lordosis and LI decreased at 1 month, 6 months, and the last follow-up ( P < 0.05), while the IHI increased when compared with that before surgery ( P < 0.05). Besides, no significant differences were observed in lumbar lordosis, LI, and IHI between the two groups at preoperative, 1 month, 6 months after surgery, and final follow-up ( P > 0.05). In addition, the fusion rates between these two groups had no significant difference ( P > 0.05). The levels of serum CRP, IL-6, and TNF-α at 12 and 24 h after operation in the two groups were higher than those before operation ( P < 0.05), but there was no significant difference in the levels of serum CRP, IL-6, and TNF-α between the two groups at 12 and 24 h after operation ( P < 0.05). In addition, none of the patients of both groups had permanent nerve injury, incision infection, and other complications. These results showed that MIS-TLIF combined with unilateral or bilateral percutaneous internal fixation technique causes less damage to the body tissues of patients with single-segment lumbar degenerative diseases, and they were considered to have similar clinical effects and imaging.

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Supramalleolar Osteotomy combined with Intra-articular Osteotomy for the Reconstruction of Malunited Supination-Adduction Ankle Fractures

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000130 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0001

Author(s):

Guo Changjun ◽

Xiangyang Xu

Keyword(s):

Ankle Fractures ◽

Ankle Arthritis ◽

Vas Score ◽

Supramalleolar Osteotomy ◽

Significant Difference ◽

Scale Scores ◽

Effective Option ◽

Vertical Impaction ◽

Control Study

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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