The indications and techniques of supramalleolar osteotomy

Abstract

The aim of this study is to demonstrate the use of supramalleolar osteotomy for correction of congenital or acquired deformities in distal tibia, ankle or foot. The current indications of the techniques and different types of fixation are presented. The purposes of this technique are to realign the lower limbs, to lessen pain and to redistribute the loads on the ankle joint. Specific supramalleolar osteotomy is indicated to address deformity at, above, or below the ankle joint as well as ankle arthrosis associated with intra-articular varus or valgus deformity. Multiplanar distal tibial deformity with angular and translational components alters the weight bearing axis of the tibia through the ankle joint. Outcomes after supramalleolar osteotomies have overall been encouraging. The results of using supramalleolar osteotomies for the treatment of distal tibial deformities of at least 10° in 13 patients with ankle pain treated with an average follow-up 34 months, showed improvements in American Orthopedic Foot and Ankle Society (AOFAS) scores from 54 to 87 points. Clinical outcomes support the use of supramalleolar osteotomies as an effective surgical option for the treatment of lower extremity deformities, whether congenital or post-traumatic. Meticulous preoperative planning of deformity correction and limb realignment helps redistribute joint forces safely and reliably within the ankle to prevent development of arthrosis or halting its progression.