Introduction: A patient with medial ankle osteoarthritis and a widened ankle mortise can be treated successfully with an oblique distal tibial osteotomy, without fibular osteotomy, to narrow the mortise and shift the weight-bearing axis to a more normal position.
Step 1 patient positioning and preoperative assessment: With the patient under spinal or general anesthesia, check for mortise widening with a valgus stress test.
Step 2 surgical approach: Expose the ankle joint through an anterior approach.
Step 3 corrective osteotomy: Perform an oblique osteotomy of the distal part of the tibia and narrow the widened mortise by shifting the osteotomized fragment.
Step 4 fixation and bone-grafting: Stabilize the osteotomy site with a locking plate and apply bone graft to the osteotomy site.
Step 5 closure: Close the soft tissue in layers.
Results: Eighteen patients (fifteen female and three male; mean age, fifty-seven years) with symptomatic medial ankle osteoarthritis and mortise widening underwent distal tibial oblique osteotomy without fibular osteotomy between 2008 and 2011.IndicationsContraindicationsPitfalls & Challenges.