Supramalleolar osteotomy for the treatment of distal tibial angular deformities and arthritis of the ankle joint

In a 5-year period (1996-2001), the authors performed supramalleolar osteotomies for the correction of distal tibial mechanical malalignment of at least 10 degrees with concomitant pain and with or without radiographic evidence of arthritic changes. The method was also applied as an alternative to other common procedures for the treatment of a small group of patients with degenerative changes of the ankle joint without previous traumatic event and with minimal or moderately altered alignment. There were 12 patients (13 feet) with an average follow-up of 33.6 months. All osteotomies healed at an average time of 14 weeks. The average AOFAS score improved from 53.8 to 87 points, the average ankle score in the scale described by Takakura et al. improved from 56.7 to 82, and the average pain score improved from 14.6 to 32.3. In the presence of deformity, the average tibial-ankle surface angles in both the coronal and the sagittal planes were significantly improved. The radiographic degenerative changes in the ankle joint showed no evidence of progression. The choice of technique did not influence the clinical or radiographic outcome or the healing time of the osteotomy.