Tricortical bone graft from lateral malleolus as an alternative for iliac crest graft in the operative treatment of foot deformities: graft harvesting technique and its application

Abstract

The paper describes the technique and application of a tricortical bone graft harvesting from the lateral malleolus. Graft harvesting does not interfere with the continuity of the fibula. Due to its structure, the graft is equivalent to a similarly structured graft taken from the iliac crest. The graft is used in osteotomies and arthrodesis within the foot and ankle joint, which require a strong piece of bone as a wedge. The author typically uses this type of graft for osteotomy of the anterior part of the calcaneus with an opening wedge (Evans’ osteotomy), calcaneal-cuboid arthrodesis, talo-calcaneal arthrodesis, especially after calcaneal fractures, Green-Grice extra-articular talo-calcaneal arthrodesis and Dwyer II of calcaneus osteotomy for the correction of varus deformity with opening wedge from the middle, opening wedge osteotomy of medial cuneiform and supplement bone defects in techniques requiring lengthening of metatarsals.