Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis
Abstract Background This study aimed to investigate the early-to-mid-term efficacy of supramalleolar osteotomy (SMO) for the management of post-traumatic ankle arthritis resulting from previous fractures. Methods A retrospective analysis was conducted on the clinical data of 19 individuals with post...
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2025-08-01
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| Online Access: | https://doi.org/10.1186/s12893-025-03087-1 |
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| author | Yun-Qing Zhao Xue-Wen Wang Heng Li Xiao-Feng Gong Yong Wu |
| author_facet | Yun-Qing Zhao Xue-Wen Wang Heng Li Xiao-Feng Gong Yong Wu |
| author_sort | Yun-Qing Zhao |
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| description | Abstract Background This study aimed to investigate the early-to-mid-term efficacy of supramalleolar osteotomy (SMO) for the management of post-traumatic ankle arthritis resulting from previous fractures. Methods A retrospective analysis was conducted on the clinical data of 19 individuals with post-traumatic ankle arthritis secondary to old fractures treated with SMO between March 2018 and September 2022. The cohort included 6 males and 13 females, aged 15 to 59 years, with an average of 37.1 ± 15.8 years. Among these cases, 12 underwent surgical treatment for their initial fractures, while 7 received conservative management. Clinical efficacy was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Foot Function Index (FFI), and Visual Analog Score (VAS) for pain. Imaging analyses were conducted using the changes of tibial anterior surface angle (TAS), talar tilt (TT) angle, and modified Takakura stage. Evaluation of patient satisfaction after surgery was conducted during the final follow-up. Results All patients were followed up for 12 to 47 months (mean follow-up: 21.9 ± 11.1 months). At the final follow-up, the AOFAS ankle-hindfoot score improved to 81.9 ± 9.8, the FFI decreased to 24.2 ± 22.8, and the VAS score decreased to 3.2 ± 3.0, all showing significant improvement compared with preoperative values (p < 0.05). The TAS angle increased significantly to 90.2° ± 5.1° postoperatively (p < 0.05), while the TT angle was 0.3° ± 2.5°, without a statistically significant change (p = 0.314). No significant progression was observed in the modified Takakura stage (p = 0.458). The overall patient satisfaction rate was 89.5% (17/19). Prognostic analysis revealed no correlation between fracture-to-surgery interval (1–27 years) and AOFAS improvement ( r = 0.233, p = 0.337). Excessive preoperative TT (> 7.3°) did not compromise outcomes after correction. Conclusions SMO demonstrates favorable early-to-mid-term efficacy in the treatment of traumatic fracture-related ankle arthritis, with significant improvements in pain relief, functional scores, and patient satisfaction. Prognostic factors (time since fracture, severe talar tilt) did not adversely affect results, supporting SMO’s utility across diverse presentations. |
| format | Article |
| id | doaj-art-3fbb87017b4f4151b4745904dd069d7e |
| institution | Kabale University |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-08-01 |
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| spelling | doaj-art-3fbb87017b4f4151b4745904dd069d7e2025-08-20T03:45:44ZengBMCBMC Surgery1471-24822025-08-0125111110.1186/s12893-025-03087-1Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysisYun-Qing Zhao0Xue-Wen Wang1Heng Li2Xiao-Feng Gong3Yong Wu4Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical UniversityAbstract Background This study aimed to investigate the early-to-mid-term efficacy of supramalleolar osteotomy (SMO) for the management of post-traumatic ankle arthritis resulting from previous fractures. Methods A retrospective analysis was conducted on the clinical data of 19 individuals with post-traumatic ankle arthritis secondary to old fractures treated with SMO between March 2018 and September 2022. The cohort included 6 males and 13 females, aged 15 to 59 years, with an average of 37.1 ± 15.8 years. Among these cases, 12 underwent surgical treatment for their initial fractures, while 7 received conservative management. Clinical efficacy was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Foot Function Index (FFI), and Visual Analog Score (VAS) for pain. Imaging analyses were conducted using the changes of tibial anterior surface angle (TAS), talar tilt (TT) angle, and modified Takakura stage. Evaluation of patient satisfaction after surgery was conducted during the final follow-up. Results All patients were followed up for 12 to 47 months (mean follow-up: 21.9 ± 11.1 months). At the final follow-up, the AOFAS ankle-hindfoot score improved to 81.9 ± 9.8, the FFI decreased to 24.2 ± 22.8, and the VAS score decreased to 3.2 ± 3.0, all showing significant improvement compared with preoperative values (p < 0.05). The TAS angle increased significantly to 90.2° ± 5.1° postoperatively (p < 0.05), while the TT angle was 0.3° ± 2.5°, without a statistically significant change (p = 0.314). No significant progression was observed in the modified Takakura stage (p = 0.458). The overall patient satisfaction rate was 89.5% (17/19). Prognostic analysis revealed no correlation between fracture-to-surgery interval (1–27 years) and AOFAS improvement ( r = 0.233, p = 0.337). Excessive preoperative TT (> 7.3°) did not compromise outcomes after correction. Conclusions SMO demonstrates favorable early-to-mid-term efficacy in the treatment of traumatic fracture-related ankle arthritis, with significant improvements in pain relief, functional scores, and patient satisfaction. Prognostic factors (time since fracture, severe talar tilt) did not adversely affect results, supporting SMO’s utility across diverse presentations.https://doi.org/10.1186/s12893-025-03087-1Ankle jointJoint preservationFractureClinical efficacyRealignment surgery |
| spellingShingle | Yun-Qing Zhao Xue-Wen Wang Heng Li Xiao-Feng Gong Yong Wu Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis BMC Surgery Ankle joint Joint preservation Fracture Clinical efficacy Realignment surgery |
| title | Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis |
| title_full | Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis |
| title_fullStr | Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis |
| title_full_unstemmed | Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis |
| title_short | Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis |
| title_sort | supramalleolar osteotomy outcomes for post traumatic fracture related ankle arthritis a retrospective analysis |
| topic | Ankle joint Joint preservation Fracture Clinical efficacy Realignment surgery |
| url | https://doi.org/10.1186/s12893-025-03087-1 |
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