Abstract
Aims: The purposes of the current retrospective study were to evaluate the outcome of a consecutive series of supramalleolar osteotomies and to identify the influence of the technique (opening versus closing wedge) on the outcome and the union rate.
Methods: In a five year period, we performed a supra-malleolar osteotomy for the correction of distal tibial mechanical malalignment of at least 10°, with concomitant pain and with or without radiographic evidence of arthritic changes, or as an alternative to other common procedures, for the treatment of a small group of patients with degenerative changes of the ankle joint.
Results: There were 14 patients (15 feet) with an average follow up of 31.1 months. All osteotomies healed at an average time of 13.6 weeks. The average AOFAS score improved from 53.8 to 87 points, the average Takakura score from 56.7 to 82 and the average pain score from 13.5 to 31.4. In the presence of deformity the average values of TAS and TLS angles were significantly improved. The radiographic degenerative changes in the ankle joint showed no evidence of progression. The choice of technique did not influence the clinical- radiographic outcome and the healing time of the osteotomy.
Conclusions: Supramalleolar osteotomy is a useful procedure to: a. reconstruct the normal mechanical environment in malunion preventing or decelerating any long term deleterious effects and improving pain and function levels, and b. to shift and redistribute loads in the ankle joint in an effort to protect the articular cartilage from further degenerative process.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
