Effect of Combined Fibular Osteotomy on the Pressure of the Tibiotalar and Talofibular Joints in Supramalleolar Osteotomy of the Ankle: A Cadaveric Study

• Published in: The Journal of foot and ankle surgery 2017-01, Vol.56 (1), p.59-64
• Main Authors: Choi, Gi Won, MD, PhD, Lee, Soon Hyuck, MD, PhD, Nha, Kyung Wook, MD, PhD, Lee, Sung Jae, PhD, Kim, Won Hyeon, BE, Uhm, Chang-Sub, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Ankle Fractures - diagnostic imaging; Ankle Fractures - surgery; ankle joint; Biomechanical Phenomena; Cadaver; Combined Modality Therapy; Compressive Strength; Female; Fibula - surgery; Humans; joint contact pressure; Linear Models; Male; Middle Aged; Multivariate Analysis; Orthopedics; Osteotomy - methods; pressure sensor; supramalleolar osteotomy; Tibia - surgery
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2016.08.003

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