Background: 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. Methods: 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. Results: 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. Conclusions: 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. (c) 2021 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Reconstruction of a missing or insufficient distal fibula in the setting of a total ankle replacement: The Milanese technique / F.G. Usuelli, C. de Cesar Netto, C. Maccario, T. Paoli, R. D'Ambrosi, C. Indino. - In: FOOT AND ANKLE SURGERY. - ISSN 1268-7731. - 28:2(2022 Feb), pp. 186-192. [10.1016/j.fas.2021.03.007]

Reconstruction of a missing or insufficient distal fibula in the setting of a total ankle replacement: The Milanese technique

R. D'Ambrosi;
2022

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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. (c) 2021 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
Ankle prosthesis; Fibula reconstruction; Insufficient fibula; Missing lateral malleolus; Ankle Joint; Humans; Range of Motion, Articular; Retrospective Studies; Treatment Outcome; Arthroplasty, Replacement, Ankle; Fibula
Settore MED/33 - Malattie Apparato Locomotore
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/946870
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