Revised version of distal tibial oblique osteotomy for ankle osteoarthritis treatment

According to the investigators of Sapporo Medical University School of Health Sciences and Hakodate Goryokaku Hospital Japan, “modified distal tibial oblique osteotomy procedure is able to prevent the necessity for iliac bone harvesting, decreases tension on medial soft tissue and sustains close bone contact for the better postoperative union, making it a better approach for ankle arthritis.

A total of seven ankles were selected from six osteoarthritis patients for this analysis. The osteotomy path involved of a slanting doglegged line from the lateral end of the distal tibia to a proximal point one-third from the lateral edge and proceeding along an arc described by the virtual coronal-plane rotation of the doglegged line to the medial edge. Next, to the osteotomy, the distal tibial fragment was revolved distally in the coronal plane for realignment while keeping the connection with the distal tibial fragment and the proximal tibia. The synthetic bone blocks were used to fill the resulting wedge-shaped gap, after which the tibial bone was protruding medially from the rotation. Further, for stabilization, a locking plate was employed.

In all subjects the bone union was attained within three months. An improvement from 38.4 to 85.7 points in the Japanese Society for Surgery of the Foot ankle-hind foot scale was noticed during the latest follow-up. No cases of nerve disturbances, healing problems or infections were reported. Multiple radiographic parameters were also recovered after the treatment. These findings present a significant efficacy of improved distal tibial oblique osteotomy.