title: Chevron-type medial malleolar osteotomy: a functional, radiographic and quantitative T2-mapping MRI analysis.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively evaluate a large series of patients for functional, radiographic and MRI outcomes after a Chevron-type medial malleolar osteotomy.
  
  
  METHODS
  Sixty-two patients underwent a Chevron-type medial malleolar osteotomy with a median follow-up of 34.5 months. Standard digital radiographs were used to determine bony union and the angle of the osteotomy relative to the longitudinal axis of the tibia. Morphologic and quantitative T2-mapping MRI was also analysed in 32 patients.
  
  
  RESULTS
  Fifty-eight patients (94 %) reported being asymptomatic at the site of the medial malleolar osteotomy. The median time to healing on standard radiograph was 6 weeks (range, 4-6 weeks) with an angle of 31.7° ± 6.9°. Quantitative T2-mapping MRI analysis demonstrated that the deep half of interface repair tissue had relaxation times that were not significantly different from normal tibial cartilage. In contrast, interface repair tissue in the superficial half demonstrated significant prolongation from normal relaxation time values, indicating a more fibrocartilaginous repair. Four patients (6 %) reported pain post-operatively.
  
  
  CONCLUSIONS
  A Chevron-type medial malleolar osteotomy demonstrates satisfactory healing and fixation, with fibrocartilaginous tissue evident superficially at the osteotomy interface. Further investigation is warranted in the form of longitudinal study to assess the long-term outcomes of medial malleolar osteotomy.
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Lamb
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Murawski
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Deyer
authors.forename: John G
authors.initials: JG
authors.lastname: Kennedy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000842:Ankle / Q000601:surgery*; D002358:Cartilage, Articular / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D013628:Talus / Q000601:surgery; D013977:Tibia / Q000503:physiopathology* / Q000601:surgery; D014945:Wound Healing; D055815:Young Adult