Safe zone for medial open-wedge supramalleolar osteotomy of the ankle: A cadaveric study

Kyung Wook Nha, Soon-Hyuck Lee, Im Joo Rhyu, Hak Jun Kim, Jae Gwang Song, Jae Hwi Han, Eui Dong Yeo, Young Koo Lee

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The purpose of this present study was to determine the incidence of lateral cortical fracture depending on the plane of osteotomy in medial open-wedge supramalleolar osteotomy (SMO) and to define a safe zone through which a medial open-wedge SMO could be performed with minimal risk of lateral cortical fracture. Materials and Methods: Matched pairs of fresh-frozen human cadaver lower leg specimens were obtained from 7 males and 3 females (average age = 63.9 [range 49-75] years). In group A, a safe zone-level medial open-wedge SMO (plane of osteotomy oriented to the proximal one-third of the intrasyndesmosis) was performed, and in group B, a higher-level medial open-wedge SMO (plane of osteotomy oriented to the suprasyndesmosis) was performed. Results: In group A, 7 of the 10 limbs had no lateral cortical fracture, and 3 had lateral cortical fracture, but all of the fractured limbs were stable during the medial open-wedge SMO procedure. In group B, 2 of 10 limbs had no lateral cortical fracture and 8 had lateral cortical fracture. Three of the 8 fractured limbs were stable, but 5 were unstable during the medial open-wedge SMO procedure. The incidence of lateral cortical fracture in group B was significantly higher compared to group A (P =.04). Conclusions: According to the present findings, lateral cortical fracture was less likely to occur when open-wedge SMO was at the plane of the proximal one-third of the intrasyndesmosis, the so-called "safe zone," than at the plane of the suprasyndesmosis. Clinical Relevance: A safe zone for medial open-wedge SMO to prevent lateral cortical fracture during the medial open-wedge SMO procedure was identified.

Original languageEnglish
Pages (from-to)102-108
Number of pages7
JournalFoot and Ankle International
Volume37
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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Osteotomy
Ankle
Extremities
Incidence
Cadaver
Leg

Keywords

  • lateral cortical fracture
  • plane of osteotomy
  • safe zone
  • supramalleolar osteotomy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Safe zone for medial open-wedge supramalleolar osteotomy of the ankle : A cadaveric study. / Nha, Kyung Wook; Lee, Soon-Hyuck; Rhyu, Im Joo; Kim, Hak Jun; Song, Jae Gwang; Han, Jae Hwi; Yeo, Eui Dong; Lee, Young Koo.

In: Foot and Ankle International, Vol. 37, No. 1, 01.01.2016, p. 102-108.

Research output: Contribution to journalArticle

Nha, Kyung Wook ; Lee, Soon-Hyuck ; Rhyu, Im Joo ; Kim, Hak Jun ; Song, Jae Gwang ; Han, Jae Hwi ; Yeo, Eui Dong ; Lee, Young Koo. / Safe zone for medial open-wedge supramalleolar osteotomy of the ankle : A cadaveric study. In: Foot and Ankle International. 2016 ; Vol. 37, No. 1. pp. 102-108.
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abstract = "Background: The purpose of this present study was to determine the incidence of lateral cortical fracture depending on the plane of osteotomy in medial open-wedge supramalleolar osteotomy (SMO) and to define a safe zone through which a medial open-wedge SMO could be performed with minimal risk of lateral cortical fracture. Materials and Methods: Matched pairs of fresh-frozen human cadaver lower leg specimens were obtained from 7 males and 3 females (average age = 63.9 [range 49-75] years). In group A, a safe zone-level medial open-wedge SMO (plane of osteotomy oriented to the proximal one-third of the intrasyndesmosis) was performed, and in group B, a higher-level medial open-wedge SMO (plane of osteotomy oriented to the suprasyndesmosis) was performed. Results: In group A, 7 of the 10 limbs had no lateral cortical fracture, and 3 had lateral cortical fracture, but all of the fractured limbs were stable during the medial open-wedge SMO procedure. In group B, 2 of 10 limbs had no lateral cortical fracture and 8 had lateral cortical fracture. Three of the 8 fractured limbs were stable, but 5 were unstable during the medial open-wedge SMO procedure. The incidence of lateral cortical fracture in group B was significantly higher compared to group A (P =.04). Conclusions: According to the present findings, lateral cortical fracture was less likely to occur when open-wedge SMO was at the plane of the proximal one-third of the intrasyndesmosis, the so-called {"}safe zone,{"} than at the plane of the suprasyndesmosis. Clinical Relevance: A safe zone for medial open-wedge SMO to prevent lateral cortical fracture during the medial open-wedge SMO procedure was identified.",
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T1 - Safe zone for medial open-wedge supramalleolar osteotomy of the ankle

T2 - A cadaveric study

AU - Nha, Kyung Wook

AU - Lee, Soon-Hyuck

AU - Rhyu, Im Joo

AU - Kim, Hak Jun

AU - Song, Jae Gwang

AU - Han, Jae Hwi

AU - Yeo, Eui Dong

AU - Lee, Young Koo

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N2 - Background: The purpose of this present study was to determine the incidence of lateral cortical fracture depending on the plane of osteotomy in medial open-wedge supramalleolar osteotomy (SMO) and to define a safe zone through which a medial open-wedge SMO could be performed with minimal risk of lateral cortical fracture. Materials and Methods: Matched pairs of fresh-frozen human cadaver lower leg specimens were obtained from 7 males and 3 females (average age = 63.9 [range 49-75] years). In group A, a safe zone-level medial open-wedge SMO (plane of osteotomy oriented to the proximal one-third of the intrasyndesmosis) was performed, and in group B, a higher-level medial open-wedge SMO (plane of osteotomy oriented to the suprasyndesmosis) was performed. Results: In group A, 7 of the 10 limbs had no lateral cortical fracture, and 3 had lateral cortical fracture, but all of the fractured limbs were stable during the medial open-wedge SMO procedure. In group B, 2 of 10 limbs had no lateral cortical fracture and 8 had lateral cortical fracture. Three of the 8 fractured limbs were stable, but 5 were unstable during the medial open-wedge SMO procedure. The incidence of lateral cortical fracture in group B was significantly higher compared to group A (P =.04). Conclusions: According to the present findings, lateral cortical fracture was less likely to occur when open-wedge SMO was at the plane of the proximal one-third of the intrasyndesmosis, the so-called "safe zone," than at the plane of the suprasyndesmosis. Clinical Relevance: A safe zone for medial open-wedge SMO to prevent lateral cortical fracture during the medial open-wedge SMO procedure was identified.

AB - Background: The purpose of this present study was to determine the incidence of lateral cortical fracture depending on the plane of osteotomy in medial open-wedge supramalleolar osteotomy (SMO) and to define a safe zone through which a medial open-wedge SMO could be performed with minimal risk of lateral cortical fracture. Materials and Methods: Matched pairs of fresh-frozen human cadaver lower leg specimens were obtained from 7 males and 3 females (average age = 63.9 [range 49-75] years). In group A, a safe zone-level medial open-wedge SMO (plane of osteotomy oriented to the proximal one-third of the intrasyndesmosis) was performed, and in group B, a higher-level medial open-wedge SMO (plane of osteotomy oriented to the suprasyndesmosis) was performed. Results: In group A, 7 of the 10 limbs had no lateral cortical fracture, and 3 had lateral cortical fracture, but all of the fractured limbs were stable during the medial open-wedge SMO procedure. In group B, 2 of 10 limbs had no lateral cortical fracture and 8 had lateral cortical fracture. Three of the 8 fractured limbs were stable, but 5 were unstable during the medial open-wedge SMO procedure. The incidence of lateral cortical fracture in group B was significantly higher compared to group A (P =.04). Conclusions: According to the present findings, lateral cortical fracture was less likely to occur when open-wedge SMO was at the plane of the proximal one-third of the intrasyndesmosis, the so-called "safe zone," than at the plane of the suprasyndesmosis. Clinical Relevance: A safe zone for medial open-wedge SMO to prevent lateral cortical fracture during the medial open-wedge SMO procedure was identified.

KW - lateral cortical fracture

KW - plane of osteotomy

KW - safe zone

KW - supramalleolar osteotomy

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