Introduction: Supramalleolar osteotomies have been reported to be effective in the treatment of moderate primary and traumatic osteoarthritis of the ankle joint.
Step 1 arthroscopic examination: Perform an arthroscopic examination prior to the osteotomy in every patient to evaluate the status of the articular cartilage of the tibia and talus.
Step 2 fibular osteotomy: Bend a seven-hole plate slightly more than the natural contour of the distal part of the fibula, insert screws, and complete the osteotomy.
Step 3 tibial osteotomy: Attempt to achieve a tibial-talar angle of 95° (5° of valgus).
Step 4 fixation and bone-grafting of tibial osteotomy site: Apply a seven-hole plate and pack graft into the osteotomy gap.
Step 5 postoperative care: After routine wound closure, apply a short leg cast and do not allow weight-bearing for six weeks after surgery.
Results: In our series of sixteen patients with moderate medial ankle osteoarthritis, the mean American Orthopaedic Foot & Ankle Society (AOFAS) score, radiographic stage, and values for all radiographic parameters measured improved significantly after surgery.
What to watch for: IndicationsContraindicationsPitfalls & Challenges.