[Z-osteotomy of distal fibula to correct widened ankle mortice after fracture].
OBJECTIVE
To analyse the clinical outcomes of the Z-osteotomy of the distal fibula to correct widened mortice of the ankle after fracture.


METHODS
Between September 2009 and February 2011, 5 patients (5 feet) with widened ankle mortice after fracture underwent Z-osteotomy. There were 4 males and 1 female, aged from 23 to 58 years (mean, 38 years). At 3 months after operation of internal fixation when function exercises were done, patients got pains. The interval between trauma and operation ranged from 5 to 36 months (mean, 13.2 months). Lateral pressure test showed positive in 2 cases and negative in 3 cases. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 50.2 +/- 17.3.


RESULTS
Primary healing of incision was achieved in all cases. Five patients were followed up 9 to 24 months (mean, 15.6 months). Mild to moderate swelling of the affected limb and anterolateral skin numbness of the ipsilateral dorsal foot occurred, and gradually improved. The clinical exam and radiology showed bone union at 12-15 weeks (mean, 13.5 weeks). Postoperative range of motion of ankle had no significant improvement. AOFAS ankle-hindfoot scores were 76.8 +/- 11.2 at 6 months after operation, and 85.4 +/- 3.2 at last follow-up, showing significant differences when compared with preoperative score (P < 0.05).


CONCLUSIONS
Shortened fibula is the main cause of widened ankle mortice after fracture; Z-osteotomy can effectively reduce the width of the ankle mortice, increase the stability of ankle joint, and decrease the complication rate.
Department of Orthopedics, the Orthopedic Surgery Center of Chinese PLA, Southwest Hospital, Third Military Medical University, Chongqing, 400038, PR China.
Xu
X
Tao
Kanglai
K
Tang
Jianbo
J
Zhou
D000328:Adult; D000842:Ankle / Q000473:pathology; D016512:Ankle Injuries / Q000601:surgery*; D000843:Ankle Joint; D005260:Female; D005360:Fibula; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D016059:Range of Motion, Articular; D013639:Tarsal Bones; D016896:Treatment Outcome