In Indonesia, arthrodesis becomes a choice of treatment in
the absence of ankle arthroplasty implants for young adults.
Arthrodesis on ankle osteoarthritis (OA) often leads to
functional impairment. Low tibiofibular osteotomy is an
alternative and it has been known to be the preferable option
for those in the productive-ages. A 22-year-old male with a
previous history of a motorbike accident, operated eight
years ago, came with persistent pain on the left ankle that has
worsened over the years. Plain radiography with a tibialankle surface angle (TAS) of 74o (normally 88o
-93o
) indicated
varus deformity. Osteotomy was performed on distal tibia
above the syndesmotic joint, as well as on the middle third of
fibula. Open wedge osteotomy of the tibia was corrected
until the normal TAS angle was reached by fluoroscopy.
Cortical allograft was used to fill the osteotomy gap.
Instrumentation was performed using a clover leaf® plate
with 6 screws insertion for fixation stability. All results were
satisfactory. Twelve weeks post-operatively, the patient was
performing activities normally. Four-month post-operative
radiological evaluation showed fusion of graft and the angle
of TAS of 89°. Post-operative functional assessment using
the American Academy of Orthopaedic Surgeon (AAOS)
Foot and Ankle Measurement (FAM) questionnaires showed
significant improvement (pre 89, post 38).