Supramalleolar Osteotomy for Tibiotalar Varus Malalignment

Malalignment can result in the development of osteoarthritis in the ankle joint whether the deformity is of primary or secondary origin. In either case, there is an altered load distribution across the joint that compromises joint functionality and interferes with the normal cartilage metabolism. In a varus deformity of the ankle with medial degenerative changes, a supramalleolar osteotomy restores the alignment of the hindfoot. Two approaches have been described to correct coronal plane deformity in the ankle joint: a lateral closing-wedge and a medial opening-wedge osteotomy. Good results have been reported for several indications. In this paper, we describe our experience with reconstruction of the varus malaligned ankle joint by means of a supramalleolar osteotomy.