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Fibular-Lengthening Osteotomy in Patient with Progressive Valgus Deformity After an Ankle Fracture

Unusual setting of medical care

Juan Miguel Gómez-Palomo, Ana Martínez-Crespo, Inés Rodríguez-Delourme, Juan Ramón García-Pérez, Miguel Martínez-Espinosa, Elvira Montañez-Heredia

Department of Orthopedic Surgery and Traumatology, Virgen de la Victoria University Hospital, Málaga, Spain

Am J Case Rep 2020; 21:e920460

DOI: 10.12659/AJCR.920460

Available online: 2020-01-24

Published: 2020-02-12

BACKGROUND: The fibular fracture requires an anatomical reduction. When a malunion occurs, it can lead to a valgus deformity with an opening of the ankle mortise.
CASE REPORT: This case deals with a 23-year-old patient with pain and limited movement in the right ankle, caused by a fracture healed in an incorrect position, with shortening of the fibula and progressive displacement of the valgus, after surgery 12 months earlier for an ankle fracture. The patient underwent a corrective procedure consisting of extemporaneous lengthening of the fibula, with interposition of autologous bone graft and fixation using a compression plate. Six months after surgery, the patient did not present pain or limited movement, and was able to return to his habitual sporting activity.
CONCLUSIONS: Fibular-lengthening osteotomy is a procedure indicated for patients with malunion fracture of the distal fibula, with shortening and progressive valgus deformity. This surgery allows the restoration of the joint surface, reduces stress on the cartilage and prevents the development of arthropathy of the ankle.

Keywords: ankle fractures, Bone Lengthening, Fractures, Malunited