Background: Post-traumatic supramalleolar deformities and malunions of ankle fusion require mostly a multiplanar correction. In cases of severe soft tissue damage, external fixation and gradual correction is a definite treatment alternative.
Method: Between 2003 and 2007 a correction of supramalleolar deformities was performed in 9 patients with the Taylor spatial frame external fixator. The mean age was 30 years (min. 12, max. 68). There were 6 patients with deformities after malunion of supramalleolar fractures and 3 patients with malunion after ankle fusion. The mean angular deformity was 30 degrees and 5 patients had a rotational malposition of 13.6 degrees (min. 5 degrees, max. 25 degrees). 5 patients needed also lengthening (min. 10 mm, max. 40 mm) of the post-traumatic deformed tibia. The mean time of the follow-up examination was 23 months (min. 12, max. 41).
Results: Anatomic correction could be achieved in all patients. The average correction time was 36 days (min. 10, max. 82) with an average time period of 163 days (min. 130, max. 218) until the fixator was removed. The healing index of the leg lengthening cases was 77 d/cm. There were 2 pin-tract infections, 1 prolongated callus formation and 1 insufficient callus formation.
Conclusion: In cases of post-traumatic supramalleolar deformities with poor soft tissue and bone quality the Taylor spatial frame is a useful tool. Angular, axial, translational and rotatory deformities are corrected simultaneously without complex and time-consuming fixator reconstructions.
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http://dx.doi.org/10.1055/s-0029-1185299 | DOI Listing |
Orthop Traumatol Surg Res
November 2024
Service de Chirurgie Orthopédique et Traumatologie, CHU de Montpellier, 371 Avenue Gaston Giraud, 34295 Montpellier Cedex 05, France; Laboratoire de Mécanique et Génie Civil, LMGC, Université de Montpellier, 860 Rue de Saint-Priest, 34090 Montpellier, France; CAOS (Computer-Assisted Orthopaedic Surgery) France, Société Française de Chirurgie Orthopédique et Traumatologie (SOFCOT), 56 Rue Boissonade, 75014 Paris, France. Electronic address:
Supramalleolar osteotomy (SMO) aims to correct extra-articular deformities of the distal lower leg. There are several indications, the most common being varus osteoarthritis of the ankle. The rationale in this indication is to modify talocrural stress and pressure distribution by reorienting the limb axis.
View Article and Find Full Text PDFFoot Ankle Orthop
October 2024
Department of Orthopaedic Surgery, University of Arizona, Tucson, AZ, USA.
Strategies Trauma Limb Reconstr
August 2024
Department of Orthopedic Surgery, Phoenix Children's Hospital, Phoenix, Arizona, United States of America.
Aim: There are significant challenges in the treatment of a severe rigid ankle equinus caused by a flat-topped talus, arthrogryposis, burn sequelae, or extensive scarring. Conventional approaches, such as soft tissue releases, often fail due to joint incongruence or compromised soft tissues, thereby necessitating supramalleolar osteotomies. The classic transverse supramalleolar osteotomy (TSO) of the distal tibia can lead to secondary anterior translation of the centre of rotation of the ankle and alters mechanical and anatomical axes.
View Article and Find Full Text PDFBiomed Eng Lett
September 2024
Department of orthopedic surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu, 42415 Republic of Korea.
Supramalleolar osteotomy (SMO) is a representative procedure to restore a malalignment in the varus ankle deformity by shifting the concentrated pressure on the medial ankle joint to the lateral area. Additionally, fibula osteotomy (FO) is selectively selected and performed according to the surgeon's preference. However, it is controversial whether FO is effective in shifting the abnormal pressure from the medial to the lateral area on the ankle joint.
View Article and Find Full Text PDFOrthop Surg
September 2024
Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical University, Peking University Fourth School of Clinical Medicine, Beijing, China.
Objective: Distal tibial deformities can significantly impact patients if left uncorrected, often leading to pain, alterations in gait, and the eventual development of post-traumatic arthritis. The criteria for surgical correction in these patients continues to be a subject of debate, while supramalleolar osteotomy (SMO) is an effective method for correcting distal tibial deformities. The purpose of this study was to evaluate and compare the clinical results of SMO using internal fixation or using computer-assisted hexapod external fixator in the treatment of distal tibial deformity.
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