Supramalleolar osteotomy enables correction of the ankle varus deformity and is associated with improvement of pain and function in the short term and long term. Despite these beneficial results, the amount of surgical correction is challenging to titrate and the procedure remains technically demanding. Most supramalleolar osteotomies are currently planned preoperatively on 2-dimensional weight-bearing radiographs and executed peroperatively using free-hand techniques. This article encompasses 3-dimensional planning and printing techniques based on weight-bearing computed tomography images and patient-specific instruments to correct ankle varus deformities.
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Correction Target of Supramalleolar Osteotomy for Early Varus Ankle Arthritis: Is Overcorrection Necessary?
Foot Ankle Int
December 2024
Seoul Foot and Ankle Center, Dubalo Orthopaedic Clinic, Seoul, Republic of Korea.
Background: The aim of this study was to investigate the clinical and radiologic outcomes following supramalleolar osteotomy for early varus ankle arthritis with the medial translation of the talus, wherein the lateral translation of the talus center to the tibial axis was used as a correction target. Another aim was to compare the results between the ankles with a normal range of medial distal tibial angle (MDTA) and overcorrected MDTA at the postoperative period to investigate the role of overcorrected MDTA after the supramalleolar osteotomy.
Methods: The study comprised 90 patients (93 ankles) with Takakura stage 2 or 3a varus ankle arthritis with the medial translation of the talus, which underwent medial opening supramalleolar osteotomy with fibular osteotomy, and the mean duration of follow-up was 50.
Supramalleolar osteotomy: technical note.
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 PDFMid-term outcomes of distal tibial oblique osteotomy in patients with rheumatoid arthritis: A report of three cases.
Mod Rheumatol Case Rep
January 2025
Department of Orthopaedic Surgery, Kashimoto Hospital, Osaka, Japan.
Although distal tibial oblique osteotomy (DTOO) has usually been indicated for noninflammatory diseases such as osteoarthritis, we encountered three patients with rheumatoid arthritis (RA) who underwent DTOO. We evaluated radiographic parameters and clinical scores, including self-reported scores for the foot and ankle [self-administered foot evaluation questionnaire (SAFE-Q)] and the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale. In all three cases, radiographic improvements were achieved along with improvements in SAFE-Q and JSSF scores after mid-term follow-up.
View Article and Find Full Text PDFOblique Dorsiflexion Osteotomy of the Distal Tibia for Fixed Ankle Equinus: Surgical Technique.
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 PDFPrediction of prognosis in supramalleolar osteotomy with or without additional fibula osteotomy by approaching a biomechanical study: a finite element analysis.
Biomed 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.
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