Osteotomies for Managing Varus and Valgus Malalignment with Total Ankle Replacement.

Total ankle replacement remains an option for varus and valgus ankles, provided that it results in a balanced, neutrally aligned ankle. Accurate preoperative assessment of the deformity is essential for appropriate selection of adjuvant procedures. Osteotomies performed proximal (tibial), within (malleolar), or distal to (calcaneal, metatarsal) the ankle, allow deformity correction. Outcomes can be expected to be as good as of those ankles without coronal plane malalignment, at least in the short-term.