Duration of Follow-up (mo)

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Barbara Allison
5 years ago
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Page 1 of 7 Fig. E-1 Fig. E-2 Fig. E-1 Medial ankle arthritis with medial translation of the talus and mortise widening.

E-2 Measurement of mortise widening (a dashed line) on a valgus stress radiograph. Fig. E-3A Fig. E-3B Figs.

Fig. E-3A Preoperative weight-bearing anteroposterior radiograph showing medial ankle osteoarthritis with mortise widening

1 Page 1 of 7 Fig. E-1 Fig. E-2 Fig. E-1 Medial ankle arthritis with medial translation of the talus and mortise widening. Note the shape of the medial malleolus (white arrow). Fig. E-2 Measurement of mortise widening (a dashed line) on a valgus stress radiograph. Fig. E-3A Fig. E-3B Figs. E-3A and E-3B Weight-bearing anteroposterior radiographs of a sixty-two-year-old woman with medial ankle osteoarthritis. Fig. E-3A Preoperative weight-bearing anteroposterior radiograph showing medial ankle osteoarthritis with mortise widening and talar tilt of 6. Fig. E-3B Weight-bearing anteroposterior radiograph at forty-seven months after distal tibial osteotomy without fibular osteotomy, showing congruent mortise and talar tilt of 6.5.

E-4A Preoperative standing anteroposterior radiograph. Fig.

2 Page 2 of 7 Fig. E-4A Fig. E-4B Figs. E-4A through E-4E A patient with stage-ii ankle osteoarthritis, according to the modified Takakura classification. Fig. E-4A Preoperative standing anteroposterior radiograph. Fig. E-4B On a valgus stress radiograph, the width of medial clear space is 3.0 mm, which is almost the same as the width of the joint space between the tibial plafond and the talar dome. Although the width of the medial clear space was 3 mm, we thought intraoperative reassessment was needed.

3 Page 3 of 7 Fig. E-4C Fig. E-4D Fig. E-4C Intraoperative photograph of valgus stress on the ankle, showing definite widening of the medial joint space of >5 mm from the anterior to the posterior part of the medial gutter. Fig. E-4D Radiograph made immediately after distal tibial osteotomy without fibular osteotomy. Fig. E-4E Radiograph made two years after surgery showing a balanced mortise. Fig. E-4E

4 Page 4 of 7 TABLE E-1 Demographic Data and Clinical and Radiographic Findings ä Case Sex Side Age (yr) Duration of Follow-up (mo) Sprain History (times/duration) Medial Clear Space Width (mm) Preop 1 F R None M R Dozens/20 yr 6 3 F R Dozens/14 yr F R Dozens/40 yr F L Dozens/4 yr F R None 7 7 M R /14 yr 4 8 F R None 3 9 F R Dozens/10 yr F R /10 yr 4 11 M L Dozens/4 yr 4 12 F L Dozens/5 yr 5 13 F R Once/12 yr 4 14 F L Once/15 yr 4 15 F R Once/5 yr F R None 5 17 F R Dozens/11 yr F L Once 4 Mean % CI *OA = osteoarthritis.

5 Page 5 of 7 TABLE E-1 (continued) Stage of Ankle Arthritis* Ipsilateral Side Medial Distal Tibial Angle (deg) Anterior Distal Tibial Angle (deg) Preop Follow-up Contralat. Side Preop. Follow-up Preop. Follow up IIIA I No evidence of OA IIIB II IIIA IIIA II No evidence of OA IIIA I IIIA IIIA I IIIA IIIA IIIB IIIA IIIA II II IIIA II II IIIB IV IIIB IIIA II IIIA II II I IIIA II II IIIA II I IIIA II No evidence of OA II II I II I II IIIA IIIA IIIA IIIA II II

6 Page 6 of 7 TABLE E-2 Preoperative and Postoperative Clinical and Radiographic Findings ä Case Talar Tilt Angle (deg) Talus Center Migration (mm) Talar Tilt Angle on Varus Stress Test (deg) Anterior Drawer Test (mm) Preop. Follow-up Preop. Follow-up Preop. Preop Mean % CI 4.8 to to to to to to 6.9 *OA = osteoarthritis.

7 Page 7 of 7 TABLE E-2 (continued) Heel Alignment Angle (deg) Preop. Follow-up Surgical Approach Postop. Timing of Hardware Removal (mo) Additional Procedures Complications* 10 3 Medial 4 None Pain over metal device 10 4 Medial 11 None Intra-articular fracture and pain over metal device Medial None None Lateral osseous impingement Medial 26 None Pain over metal device Medial 20 None Pain over metal device Medial 12 None Pain over metal device 8 1 Medial 17 None Lateral osseous impingement and pain over metal device Anterior None None Lateral osseous impingement 4 7 Anterior None None Lateral osseous impingement and progression of ankle OA Anterior None None None Anterior None None None Anterior None None None Anterior 17 None Pain over metal device Anterior None None Lateral osseous impingement 4 9 Anterior None None None Anterior 10 None Pain over metal device 5 12 Anterior 5 None Pain over metal device Anterior None Medial calcaneal Lateral osseous impingement osteotomy to to 4.6

Comparison of clinical outcome according to the congruency of lateral talar gutter in oblique supramalleolar osteotomy without fibular osteotomy

Comparison of clinical outcome according to the congruency of lateral talar gutter in oblique supramalleolar osteotomy without fibular osteotomy Moses Lee, MD; Woo Jin Choi, MD, PhD, Seung Hwan Han, MD,