1. Reconstruction of a missing or insufficient distal fibula in the setting of a total ankle replacement: The Milanese technique
- Author
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Federico Giuseppe Usuelli, Tommaso Paoli, Cristian Indino, Cesar de Cesar Netto, Riccardo D’Ambrosi, and Camilla Maccario
- Subjects
Range of Motion ,musculoskeletal diseases ,medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Radiography ,Replacement ,Ankle replacement ,Missing lateral malleolus ,Arthroplasty ,Arthroplasty, Replacement, Ankle ,03 medical and health sciences ,0302 clinical medicine ,Ankle prosthesis ,Settore MED/33 - Malattie Apparato Locomotore ,medicine ,Fibula reconstruction ,Insufficient fibula ,Ankle Joint ,Humans ,Range of Motion, Articular ,Retrospective Studies ,Treatment Outcome ,Fibula ,Orthopedics and Sports Medicine ,Contraindication ,030222 orthopedics ,business.industry ,030229 sport sciences ,Surgery ,medicine.anatomical_structure ,Distal fibula ,Ankle ,business ,Range of motion ,Articular - Abstract
The presence of an intact distal fibula is reported as a prerequisite when considering total ankle replacement and its lack is usually considered a contraindication. The purpose of the study was to describe the results of a surgical technique to reconstruct the distal fibula (Milanese fibular reconstruction technique) in the setting of a total ankle replacement and insufficient fibula.Retrospective analysis of 15 patients (15 ankles) who underwent rotational fibular reconstruction technique with minimum follow-up of 24 months. Patients were evaluated preoperatively and at the last follow-up with AOFAS Ankle and Hindfoot score, VAS pain scale, SF-12 and range of motion. Standard weightbearing radiographs were used for radiographic assessment.The average of all clinical scores significantly improved (P.001). The average radiographic parameters showed a neutral alignment. No cases of reabsorption of the new lateral malleolus were observed even in cases with complications that accounted for 2 superficial wound infection and 2 deep infections.The Milanese fibular reconstruction technique can successfully reestablish a lateral strut and in the setting of an ankle prosthesis in patients with an insufficient fibula.
- Published
- 2022