Fibular Lengthening for Malunited Ankle Fractures

Abstract

We present our early experience with a simpler fibular osteotomy to correct the ankle joint alignment for malunited fibular fractures which was successful at short-term followup.

Treatment of malunion in ankle fractures

“…Functional outcome can be measured on the AOFAS score [1]. Progression of pre-existing degenerative signs in some patients is described in all series [2][3][4][5][6][7][8]. It can be estimated that, over a follow-up period of 3-7 years [2][3][4]7], 10-15% of all patients will need further surgery in the form of ankle fusion.…”

“…However, within a follow-up period of 3-7 years [2][3][4]7], revisions to ankle arthrodeses will be necessary in 10-15% of all cases. …”

“…The most important indication for surgery is pain. If no or few degenerative changes are present, an osteotomy of some sort should be performed [2][3][4]. Only in cases of severe arthritis and/or deformation will ankle arthrodesis be indicated [5][6][7][8].…”

Delayed Reconstruction of Post Traumatic Ankle Malunion: A case report

“…The transverse fibular osteotomy has been widely established to regain fibular length. 1,6,10,[11][12][13][14][15] This is common in Weber C malunions. However, re-creation of the original fracture has only been mentioned in malunions with length and rotational components.…”

“…1,3,[5][6][7][8][9][10][11][12][13][14][15] Ankle fractures occur frequently with an unfortunate propensity for malunion if not treated, or under corrected. Despite the ankle joint's chondrocyte leniency toward increased demands, the ankle joint doesn't tolerate mal-alignment well.…”