A Cohort Study of Patients Undergoing Distal Tibial Osteotomy without Fibular Osteotomy for Medial Ankle Arthritis with Mortise Widening

Abstract

Distal tibial osteotomy without fibular osteotomy reduces pain in the short term in patients with ankle arthritis, a widened mortise, and minimal talar tilt.

Effect of Combined Fibular Osteotomy on the Pressure of the Tibiotalar and Talofibular Joints in Supramalleolar Osteotomy of the Ankle: A Cadaveric Study

“…Medial opening-wedge supramalleolar osteotomy with fibular osteotomy can cause more lateral translation of the talus than medial opening-wedge supramalleolar osteotomy without fibular osteotomy. Combined fibular osteotomy and distal tibial osteotomy facilitates translation of the distal fragment, but the amount of shift of the osteotomized fragment is limited by the fibula after distal tibial osteotomy without fibular osteotomy (17,18). Our results coincide with these findings, showing that combined fibular osteotomy significantly decreases the talar translation ratio.…”

The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study

“…In previous studies, the authors recommended fibular osteotomy as a standard procedure for the treatment of varus ankle OA [2, 12, 16]. However, some studies recommended preserving the fibula in all cases [3, 11, 17, 18]. We based the decision to perform the fibular osteotomy on the pre- and intraoperative evaluation.…”

“…The role of TT in SMOT is highly controversial. Some authors have reported a significant decrease of the TT [4, 7, 8, 11, 17]; however, others have not [3, 12, 15, 19]. Tanaka et al [12] reported that in all patients with a preoperative TT greater than 10°, the joint space did not return to normal.…”

“…Previous studies have reported that SMOT could restore the weight-bearing alignment of the ankle joint [3–5], decrease the contact pressure of the medial part of the tibiotalar joint [6], restore the congruence of the tibiotalar joint surface [5, 7, 8], improve the chondromalacia [9], postpone the OA progress [10], and even reverse the radiological ankle OA stages [2, 9, 11, 12]. …”

“…Some authors have proposed combined fibular osteotomy for all SMOT patients [2, 12–16], some have suggested that the fibula should always be preserved [3, 11, 17, 18], and some authors have performed fibular osteotomy depending on the conditions [4, 5, 7, 19]. Few studies have focused on the role of the fibula in SMOT.…”