Fibular-Lengthening Osteotomy in Patient with Progressive Valgus Deformity After an Ankle Fracture

Abstract

Unusual setting of medical care Background: The fibular fracture requires an anatomical reduction. When a malunion occurs, it can lead to a valgus deformity with an opening of the ankle mortise. Case Report: This case deals with a 23-year-old patient with pain and limited movement in the right ankle, caused by a fracture healed in an incorrect position, with shortening of the fibula and progressive displacement of the valgus, after surgery 12 months earlier for an ankle fracture. The patient underwent a corrective procedure consisting of extemporaneous lengthening of the fibula, with interposition of autologous bone graft and fixation using a compression plate. Six months after surgery, the patient did not present pain or limited movement, and was able to return to his habitual sporting activity. Conclusions: Fibular-lengthening osteotomy is a procedure indicated for patients with malunion fracture of the distal fibula, with shortening and progressive valgus deformity. This surgery allows the restoration of the joint surface, reduces stress on the cartilage and prevents the development of arthropathy of the ankle.

“Plyometric Exercises to Increase Strength, Resistance and Power as a Preventive Method of Patelofemoral Pain Syndrome in Folk Dancers”

“…youth. " (Gómez Palomo et al, 2017). Its prevalence in this period of life may be due to the fact that the activities practiced, such as sports or recreational activities, imply a physical demand with a greater impact on the joints of the lower limbs, favoring the appearance of the syndrome.…”

“…There are various factors that can lead to an overload of the joint, but the vast majority result from its poor use or the mechanical demands placed on it. It is stated that: "several risk factors have been described, such as overuse or overload, poor alignment, previous trauma, abnormal travel or traction of the patella, an alteration of tissue homeostasis and even a certain psychological profile" (Gómez Palomo et al, 2017). These risk factors may occur due to the activities that are practiced throughout the day, as in the case of folk dance, it is an activity in which factors such as overload, poor structural alignment due to the techniques, that are practiced and constant trauma to the joint.…”

“…"The strength deficit when performing knee extension has been included as an important predictor of RDS, so that the biomechanical properties of the vastus medialis oblique and the vastus lateralis of the quadriceps are altered in this pathology. " (Gómez Palomo et al, 2017).…”

“…In folk dance, patellofemoral pain syndrome represents a constant condition among dancers, even Gómez Palomo mentions that: "SDR is the overuse injury that most affects people who practice ballet and the prevalence is higher in the technically disciplined more demanding, classical ballet" (Gómez Palomo et al, 2017). This tells us that in dance with high mechanical demands the syndrome may be present, causing a considerable limitation in the performance of the activity, affecting physical performance.…”

“…Within these capacities, strength, resistance and power are distinguished, which when developed, intervene as a prevention method for the mechanical demands of dance; "Strengthening the quadriceps muscles seems to lead to a decrease in patellar-femoral overload, with a consequent improvement in pain and function. " (Gómez Palomo et al, 2017), creating protection of the joint and avoiding alterations that trigger patellofemoral pain syndrome.…”