Supramalleolar Osteotomy in Patients with Varus Ankle Osteoarthritis.

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.