Alexej Barg1, Timothy L Kahn2, Graham Dekeyser2, Yantarat Sripanich2, Victor Valderrabano3. 1. Department of Orthopaedics, University of Utah, 590 Wakara Way, 84108, Salt Lake City, UT, USA. alexej.barg@hsc.utah.edu. 2. Department of Orthopaedics, University of Utah, 590 Wakara Way, 84108, Salt Lake City, UT, USA. 3. SWISS ORTHO CENTER, Schmerzklinik Basel, Swiss Medical Network, Hirschgässlein 15, 4010, Basel, Switzerland.
Abstract
BACKGROUND: The aim of this study was to assess the short-term clinical and radiographic outcomes in patients who underwent realigning Z‑shaped fibular osteotomy. METHODS: Between January 2007 and December 2014, 28 patients with a painful fibular malunion underwent a Z-shaped realignment fibular osteotomy. The mean age was 42.2 ± 14.1 years (range 19.1-67.8 years) and the mean follow-up was 7.0 ± 1.7 years (range 4.0-9.7 years), with no loss to follow-up. Weight-bearing radiographs were used to determine the distal fibula alignment based on Weber's criteria. Degenerative changes of the tibiotalar joint were assessed using the Kellgren-Lawrence scale. Clinical assessment included pain evaluation, measurement of ankle range of motion (ROM), sports activities, and quality of life outcomes. RESULTS: There were no intraoperative or perioperative complications. No delayed unions or nonunions were observed. One patient had radiographic progression of degenerative changes in the tibiotalar joint. Postoperative complications included removal of hardware (n = 15) and arthroscopic tibiotalar joint debridement (n = 2). At the last follow-up the mean visual analog scale (VAS) decreased from 6.5 ± 1.1 to 2.1 ± 1.1 (p < 0.001),the ROM improved from 39º ± 6º to 45º ± 4.5º (p < 0.001), the short form health survey questionnaire (SF-36) physical and mental outcome scores improved from 49 ± 8 to 84 ± 7 (p < 0.001) and from 61 ± 4 to 83 ± 5 (p < 0.001), respectively. CONCLUSION: The Z‑shaped realignment osteotomy of the distal fibula can provide pain relief and functional improvement in the treatment of fibular malunion. Further studies are needed to address long-term outcomes in this patient cohort.
BACKGROUND: The aim of this study was to assess the short-term clinical and radiographic outcomes in patients who underwent realigning Z‑shaped fibular osteotomy. METHODS: Between January 2007 and December 2014, 28 patients with a painful fibular malunion underwent a Z-shaped realignment fibular osteotomy. The mean age was 42.2 ± 14.1 years (range 19.1-67.8 years) and the mean follow-up was 7.0 ± 1.7 years (range 4.0-9.7 years), with no loss to follow-up. Weight-bearing radiographs were used to determine the distal fibula alignment based on Weber's criteria. Degenerative changes of the tibiotalar joint were assessed using the Kellgren-Lawrence scale. Clinical assessment included pain evaluation, measurement of ankle range of motion (ROM), sports activities, and quality of life outcomes. RESULTS: There were no intraoperative or perioperative complications. No delayed unions or nonunions were observed. One patient had radiographic progression of degenerative changes in the tibiotalar joint. Postoperative complications included removal of hardware (n = 15) and arthroscopic tibiotalar joint debridement (n = 2). At the last follow-up the mean visual analog scale (VAS) decreased from 6.5 ± 1.1 to 2.1 ± 1.1 (p < 0.001),the ROM improved from 39º ± 6º to 45º ± 4.5º (p < 0.001), the short form health survey questionnaire (SF-36) physical and mental outcome scores improved from 49 ± 8 to 84 ± 7 (p < 0.001) and from 61 ± 4 to 83 ± 5 (p < 0.001), respectively. CONCLUSION: The Z‑shaped realignment osteotomy of the distal fibula can provide pain relief and functional improvement in the treatment of fibular malunion. Further studies are needed to address long-term outcomes in this patient cohort.
Authors: Alexej Barg; Travis Bailey; Martinus Richter; Cesar de Cesar Netto; François Lintz; Arne Burssens; Phinit Phisitkul; Christopher J Hanrahan; Charles L Saltzman Journal: Foot Ankle Int Date: 2017-11-24 Impact factor: 2.827
Authors: John G Anderson; Donald R Bohay; John D Maskill; Kuldeep P Gadkari; Thomas M Hearty; William Braaksma; Michelle A Padley; Kevin T Weaver Journal: Foot Ankle Int Date: 2015-06-24 Impact factor: 2.827
Authors: Rebecca Amy Cerrato; Amiethab A Aiyer; John Campbell; Clifford L Jeng; Mark S Myerson Journal: Foot Ankle Int Date: 2014-07-23 Impact factor: 2.827