title: Staged reconstruction of a multiplane post-traumatic deformity: a case report.
abstract: Damaging effects of joint function can occur after fractures of the lower extremity that have healed with an angular malunion. Surgical techniques have been described to restore the normal mechanics and establish a plantigrade foot, including osteotomy and fusion. In the present report, we describe a unique case of a 17-year-old male who had initially experienced a severe injury to his left lower extremity and foot when he had been run over by a jeep. Originally, a Lisfranc injury with navicular and cuboid fractures were surgically corrected. He had also sustained an extra-articular distal tibial and fibular fracture, which had been conservatively managed. Seven months after the initial incident, he underwent 3-staged reconstructive surgery because of a malaligned valgus ankle with fibular malunion and a painful collapsing pes planovalgus deformity. A supramalleolar tibial osteotomy with fibular lengthening was first performed, followed by triple arthrodesis with removal of hardware and then syndesmosis repair. The present report discusses our clinical evaluation and surgical technique for this multiplanar post-traumatic deformity.
authors.affiliation: Attending Surgeon, Dekalb Medical Residency Program; Faculty, Podiatry Institute, Decatur, GA; and Foot and Ankle Clinic of Oakwood, Oakwood, GA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Brosky
authors.affiliation: Attending Surgeon, Dekalb Medical Residency Program; Faculty, Podiatry Institute, Decatur, GA; and Foot and Ankle Clinic of Oakwood, Oakwood, GA; Faculty, Podiatry Institute, Decatur, GA; and Ankle and Foot Centers of Georgia, Jonesboro, GA. Electronic address: mannjj0618@gmail.com.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Mann
authors.affiliation: Attending Surgeon, Dekalb Medical Residency Program; Faculty, Podiatry Institute, Decatur, GA; and Foot and Ankle Clinic of Oakwood, Oakwood, GA.
authors.forename: Sean Patrick
authors.initials: SP
authors.lastname: Dunn
authors.affiliation: Resident, Dekalb Medical, Decatur, GA.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Gonzalez
mesh_terms: D000293:Adolescent; D064591:Allografts; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D064592:Autografts; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016025:Bone Transplantation; D005360:Fibula / Q000293:injuries / Q000601:surgery; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005592:Fracture Fixation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010027:Osteotomy; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000628:therapy*
keywords: fibular lengthening; malunion; supramalleolar osteotomy; syndesmosis; triple arthrodesis