Background
Angular deformities of the leg resulting from malunion of distal tibial fractures or
physeal arrest in skeletally immature patients are usually associated with ankle and
foot pain secondary to disturbed mechanics and joint overload and could inevitably
lead − if uncorrected − to degenerative arthritis. This prospective, case series study
aims to evaluate the functional and radiological outcomes of supramalleolar
corrective osteotomies for treating symptomatic angular deformities of the tibia
and to assess its role in preventing or postponing degenerative arthritis of the ankle
joint.
Patients and methods
This study included 18 patients presented with symptomatic angular tibial
deformities secondary to malunion of previous distal tibial fractures or posttraumatic
physeal arrest. Twelve patients had varus deformities of the ankle,
while six patients had valgus deformities. Partial fibulectomy proximal to the
level of the planned osteotomy was initially done in all patients; varus
deformities were corrected with medial opening-wedge osteotomy and bone
grafting with or without tibial fixation, while valgus deformities were corrected
with medial closing-wedge osteotomy fixed by plates and screws. The
ankle–hindfoot scale of the American Orthopaedic Foot and Ankle Society was
used for evaluating the functional results preoperatively and postoperatively.
Results
The mean age of the patients at presentation was 17.6±5.9 years (ranged from 10
to 44 years). All the osteotomies united in an average duration of 10±4.8 weeks
(ranged from 7 to 15 weeks) with no reported surgery-related complications apart
from delayed wound healing in two cases. The deformity was clinically improved in
all the 18 patients, while the radiological parameters were satisfactory in 16 patients
with statistically significant improvement (P |
