Supramalleolar tibial osteotomy for the prevention of asymmetric crus arthrosis

Post-traumatic or congenital varus deformity of the distal third of the tibia leads to disruption of anatomical relationships in the ankle joint, resulting in deformative osteoarthritis (DOA) of the ankle, which is a serious complication. The lower extremities of the human body have specific characteristics that must be considered in any reconstructive surgery, such as external appearance, disruption of physiological limb anatomy, disruption of reference lines and angles. The blood supply to the ankle joint is peculiar due to the absence of a muscular mass around the ankle region; in case of injury, microcirculatory activity sharply decreases, leading to local tissue hypoxia, which is also a contributing factor in the development of DOA. This literature review analyzes sources on the correction of post-traumatic and congenital deformities of the distal part of the tibia in asymmetric ankle osteoarthritis, sourced from PubMed, Google Scholar, SCOPUS, and Web of Science databases. Currently, various surgical interventions are used to prevent the development of DOA, showing promising results. The most common method is corrective supramalleolar osteotomy of the tibia, as one of the radical treatment options. This procedure is performed to optimize the biomechanics of the ankle joint and preserve its functional capacity, thereby preventing ankle arthritis and potentially delaying ankle joint arthroplasty or arthrodesis. Keywords: Asymmetric ankle osteoarthritis, post-traumatic varus deformity of the distal tibia, congenital varus deformity of the distal tibia, supramalleolar osteotomy, opening wedge osteotomy, closing wedge osteotomy.