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Updated: Jul 19, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
[Cleft foot with Y-shaped deformity of the third metatarsus. A case history.]
1Orthopädische Universitätsklinik, Michaelisstraße 1, D-24105, Kiel.
Goal Of Surgery:
Correction of the deformity of the third metatarsus and of the malposition of the toes to improve form and function of the foot.
Indications:
Problems with shoe wear. Aesthetic appearance. (Limitation of function.)
Contraindications:
None.
Preoperative Work Up:
Drawing of surgery to be performed.
Positioning And Anaesthesia:
Supine. General anaesthesia.
Surgical Technique:
Excision of the distal half of the hypoplastic second metatarsus through a curvilinear dorsal incision. Osteotomy of the third metatarsus at the Y-junction and implantation of the mediodistal part into the proximal half of the second metatarsus. Corrective osteotomy of the third metatarsus at the Y-junction. Internal fixation of both metatarsi with transosseous, transarticular Kirschner wires. Four weeks later correction of the hallux valgus using the technique recommended by Kramer.
Postoperative Management:
Below knee plaster of Paris. Removal of K'wires after consolidation of osteotomies. Progressive increase in weight bearing. Arch supports.
Possible Complications:
Injury to nerves, vessels or tendons. Wound infection. Delayed consolidation. Nonunion. Growth disturbances.
Results:
30 months postoperatively, when the patient was 13 years of age, both osteotomies had healed in good position: the foot looked nearly normal. At 21 years of age the patient has no problems. She is involved in sports and is satisfied with the result.