Nonunion after medial malleolar osteotomy in total ankle arthroplasties for severe varus deformity: a report of 3 cases

Author:

Okamura Gensuke1,Hirao Makoto1ORCID,Noguchi Takaaki2,Etani Yuki2,Ebina Kosuke2,Miura Taihei2,Tsuboi Hideki3,Goshima Atsushi3,Okada Seiji2,Hashimoto Jun1

Affiliation:

1. Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center , Osaka 586-8621 , Japan

2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine , Osaka 565-0871 , Japan

3. Department of Orthopaedic Surgery, Osaka Rosai Hospital , Osaka 591-8025 , Japan

Abstract

Abstract Of the three ankles after total ankle arthroplasty (TAA) with medial malleolar osteotomy for severe varus deformity (talar varus tilt >10°), two failed in varus migration of the tibial component. In these two cases, tibial osteotomy was performed with varus alignment of 5°and 2°, and with medially shifted placement of tibial component, while one ankle showed no migratoin of prostheses after 5 years, even with nonunion. In this case, tibial osteotomy was performed with a valgus alignment of 4°. Internal fixation after medial malleolar osteotomy should be done for severe varus cases. Medially shifted placement of tibial component should be avoided. Fortunately, the failure did not occur in a case of valgus of the distal tibia. Valgus tibial osteotomy might help to reduce the collision of the talus against the medial malleolus.

Publisher

Oxford University Press (OUP)

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