Staged Reconstruction of a Multiplane Post-traumatic Deformity: A Case Report |
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| Institution: | 1. Attending Surgeon, Dekalb Medical Residency Program; Faculty, Podiatry Institute, Decatur, GA; and Foot and Ankle Clinic of Oakwood, Oakwood, GA;2. Faculty, Podiatry Institute, Decatur, GA; and Ankle and Foot Centers of Georgia, Jonesboro, GA;3. Resident, Dekalb Medical, Decatur, GA;1. Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA;2. Department of Orthopaedic Surgery, Franciscan Alliance, Michigan City, IN, USA;3. Orthopaedic Associates of Michigan, Grand Rapids, MI, USA;4. Rehabilitation Institute of Chicago, Chicago, IL, USA;5. Rehabilitation Institute of Chicago, Chicago, IL, USA;1. Director, Foot and Ankle Surgical Residency Program, Regions Hospital and HealthPartners Institute for Education and Research, St. Paul, MN;2. Chief Resident, Department of Foot and Ankle Surgery, Regions Hospital and HealthPartners Institute for Education and Research, St. Paul, MN;1. Food and Hand Division, Department of Orthopedics, Friedrich-Schiller-University Jena, Waldkrankenhaus “Rudolf Elle” GmbH, Klosterlausnitzer Straße 81, D-07607 Eisenberg, Germany;2. Leiter Fuß- und Sprunggelenkchirurgie, Arkadenklinik Filderstadt GmbH, Nürtinger Str. 11, 70794 Filderstadt, Germany;3. Department of Trauma, Hand and Reconstructive Surgery, Friedrich-Schiller-University Jena, Germany;4. Vice Rector of Research, Technical University of Varna, 1, Studentska Str., 9010 Varna, Bulgaria;5. Department of Traumatology and Orthopaedic Surgery, Helios Klinikum Erfurt, Nordhäuser Straße 74, 99089 Erfurt, Germany;6. Foot and Ankle Surgery, Gelenkzentrum Rhein-Main, Wilhelmstraße 30, 65183 Wiesbaden, Germany |
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| Abstract: | Damaging effects of joint function can occur after fractures of the lower extremity that have healed with an angular malunion. Surgical techniques have been described to restore the normal mechanics and establish a plantigrade foot, including osteotomy and fusion. In the present report, we describe a unique case of a 17-year-old male who had initially experienced a severe injury to his left lower extremity and foot when he had been run over by a jeep. Originally, a Lisfranc injury with navicular and cuboid fractures were surgically corrected. He had also sustained an extra-articular distal tibial and fibular fracture, which had been conservatively managed. Seven months after the initial incident, he underwent 3-staged reconstructive surgery because of a malaligned valgus ankle with fibular malunion and a painful collapsing pes planovalgus deformity. A supramalleolar tibial osteotomy with fibular lengthening was first performed, followed by triple arthrodesis with removal of hardware and then syndesmosis repair. The present report discusses our clinical evaluation and surgical technique for this multiplanar post-traumatic deformity. |
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| Keywords: | fibular lengthening malunion supramalleolar osteotomy syndesmosis triple arthrodesis |
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