Fibular osteotomy and distal tibiofibular joint fusion for treatment of chronic malunited ankle fracture

Abstract

Objective To report the clinical treatment of chronic malunited ankle fractures by fibular osteotomy and distal tibiofibular joint fusion. Methods A retrospective analysis was done of the 36 patients with chronic malunited ankle fracture who had been treated from March 2013 to January 2016 in our hospital. They were 20 men and 16 women, aged from 25 to 59 years (average, 36.7 years). They were treated by open reduction, fibular osteotomy to correct their rotation deformity, and distal tibiofibular joint fusion. The therapeutic efficacy was assessed postoperatively by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Results They were followed up for 10 to 36 months (average, 26.5 months). No nonunion, implant failure or infection was observed. The AOFAS ankle-hindfoot score in-creased significantly from preoperative 36.4±7.8 to 82.1±9.4 at the final follow-up (t=73.379, P=0.000). An excellent and good rate of 86.1% was achieved, giving 9 excellent, 22 good and 5 fair cases. Mild limitation in ankle flexion and extension was observed in 5 cases. No significant differences were found between final fol-low-ups and preoperation regarding the ankle plantar flexion (32.0°±2.4° versus 31.8°±3.5°) or the ankle dorsal extension (18.2°±1.7° versus 17.4°±2.4°)(P >0.05). Conclusion Fibular osteotomy and distal tibiofibular joint fusion can result in fine clinical effects in the treatment of chronic malunited ankle fractures. Key words: Ankle fracture; Fractures, bone; Osteotomy; Distal tibiofibular joint fusion; Malunion