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Medial oblique malleolar osteotomy for approach of medial osteochondral lesion of the talus

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

The medial malleolar osteotomy is commonly performed to gain access to the medial talar dome for treatment of osteochondral lesions of the talus. The primary aim of this study was to assess osseous healing based on postoperative radiographs to determine consolidation, non-union and malreduction rates.

Methods

Sixty-seven cases were reviewed where an oblique uniplanar medial malleolar osteotomy was performed to gain access to the medial talar dome for addressing an osteochondral lesion. Two, respectively three fully threaded 3.5 mm corticalis screws were used to fixate the osteotomy. Postoperative radiographs were reviewed to assess consolidation, non-union, malreduction and dislocation of the osteotomy.

Results

Out of 67 patients, 66 patients had a consolidation of the osteotomy. 23.9% of the cases showed malreduction of the osteotomy. One patient suffered a non-union, which required a revision surgery. No significant difference was shown between two and three screws used for fixation in terms of malreduction and consolidation of the osteotomy. Eighty-four percent of the patients underwent hardware removal due to pain or medial impingement.

Conclusion

The oblique medial malleolar osteotomy is a safe and relatively simple procedure with a high consolidation rate and low revision providing excellent exposure of the talus. The moderately high malreduction rate and required hardware removal surgery by most of the patients are relevant factors which should be considered before performing this surgery.

Level of evidence

Level III, retrospective cohort study.

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Acknowledgements

Our friend and colleague Prof. Dr. Alexej Barg helped with the statistical analysis of this paper. We are saddened to inform you that he passed away unexpectedly at an young age of forty-two. Alexej was a dedicated worker who was more focused on the success of his team than his personal benefit. He made many great contributions to orthopedic research and helped it move forward in various ways. Alexej's kind personality, sense of humor and boundless talent will be sorely missed. His work will not soon be forgotten.

Funding

No funding or grants were obtained for this study.

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Authors and Affiliations

  1. Orthopaedic and Trauma Department, Kantonsspital Winterthur, Winterthur, Switzerland

    Michel Meisterhans

  2. Swiss Ortho Center, Schmerzklinik Basel, Swiss Medical Network, Hirschgässlein 15, 4010, Basel, Switzerland

    Victor Valderrabano

  3. WinOrtho, Privatklinik Lindberg, Swiss Medical Network, Schickstrasse 11, 8400, Winterthur, Switzerland

    Martin Wiewiorski

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  1. Michel Meisterhans
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Correspondence to Michel Meisterhans.

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Conflict of interest

MM, VV, MW or their immediate family, or any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Approval for the study was obtained from the ethical committee of the University of Basel. All subjects gave informed consent to participate. The study was carried out in accordance with the World Medical Association Declaration of Helsinki.

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Meisterhans, M., Valderrabano, V. & Wiewiorski, M. Medial oblique malleolar osteotomy for approach of medial osteochondral lesion of the talus. Arch Orthop Trauma Surg 143, 3767–3778 (2023). https://doi.org/10.1007/s00402-022-04598-9

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