Abstract
We investigated the effect of combined fibular osteotomy on the pressure of the tibiotalar
and talofibular joints in medial opening-wedge supramalleolar osteotomy. Three different
tibial osteotomy gaps (6, 8, and 10 mm) were created in 10 cadaveric models, and the
pressure in the tibiotalar and talofibular joints was measured under axial load before
and after fibular osteotomy. The heel alignment angle and talar translation ratio
were evaluated radiographically. An increase in osteotomy gap led to increases in
hindfoot valgus (p = .001) and the contact and peak pressures in the talofibular joint (p = .03 and p = .004). In contrast, the contact and peak pressures in the tibiotalar joint were
unchanged with an increasing osteotomy gap (p = .52 and p = .76). Fibular osteotomy reduced the contact and peak pressures in the talofibular
joint (p < .001 and p = .001, respectively), and it did not influence the contact and peak pressures in
the tibiotalar joint (p = .46 and p = .14, respectively). Therefore, fibular osteotomy might be necessary in supramalleolar
osteotomy for medial ankle arthritis to minimize the increase in pressure in the talofibular
joint, especially when the osteotomy gap is large.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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© 2016 by the American College of Foot and Ankle Surgeons. All rights reserved.
