Woo-Chun Lee1, Jeong-Seok Moon1, Kang Lee1, Woo Jin Byun1, Sang Hyeong Lee1. 1. Department of Orthopaedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, Number 85, 2-ga, Jeo-dong, Jung-Gu, Seoul, 100-032, South Korea. E-mail address for W.-C. Lee: lwsk980@unitel.co.kr.
Abstract
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.
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.