Extraarticular Supramalleolar Osteotomy for Managing Varus Ankle Osteoarthritis, Alternatives for Osteotomy: How and Why?

The supramalleolar osteotomy has been reported to be a joint preserving surgery with good clinical outcome for asymmetric ankle osteoarthritis, especially varus ankle osteoarthritis. Conventional supramalleolar osteotomy of the tibia and fibula creates angulation and translation of the ankle joint without changing the width of the ankle mortise. Distal tibial oblique osteotomy improved the preoperative clinical and radiological parameters; however, mean talar tilt angle did not decrease. Assessment of the ankle arthritis in sagittal, axial, and coronal planes may be helpful to achieve a decrease of the talar tilt in ankle osteoarthritis.