title: Lengthening z-osteotomy of the fibula to correct persistent talar shift following open reduction internal fixation of ankle fractures.
abstract: BACKGROUND
  In cases where ankle fracture union has been compromised by persistent syndesmotic diastasis following open reduction internal fixation, both external rotation and shortening of the fibula have been identified as prominent features.
  
  
  OBJECTIVE
  This study reports a technique that uses a z-osteotomy to achieve both lengthening and internal rotation of the fibula to correct persistent talar shift following ankle fracture fixation.
  
  
  METHODS
  Four patients with persistent talar shift following open reduction internal fixation for an ankle fracture received z-osteotomy of the fibula to achieve both lengthening and internal rotation.
  
  
  RESULTS
  At the latest clinic review, all 4 ankles exhibited satisfactory clinical and radiological union. All patients have returned to full mobility and are satisfied with the outcome.
  
  
  CONCLUSIONS
  This study demonstrates the effectiveness of lengthening z-osteotomy of the fibula in correcting persistent talar shift following internal fixation of ankle fractures.
  
  
  METHODS
  Therapeutic Level V.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Sandwell and West Birmingham Hospitals, Lyndon, West Bromwich, West Midlands, UK. tanujan1@hotmail.com
authors.forename: Tanujan
authors.initials: T
authors.lastname: Thangarajah
authors.forename: Ayaz
authors.initials: A
authors.lastname: Lakdawala
authors.forename: Emir
authors.initials: E
authors.lastname: Battaloglu
authors.forename: Atul
authors.initials: A
authors.lastname: Malik
authors.forename: Abhay
authors.initials: A
authors.lastname: Tillu
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000503:physiopathology / Q000601:surgery; D017760:Bone Malalignment / Q000503:physiopathology / Q000601:surgery*; D005360:Fibula / Q000601:surgery*; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods*; D013628:Talus / Q000503:physiopathology*; D055815:Young Adult