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Updated: Jul 17, 2026
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Results of step-cut medial malleolar osteotomy
David B Thordarson1, Shawn K Kaku
1USC Department of Orthopaedic Surgery, 1520 San Pablo Avenue, Suite 2000, Los Angeles, CA 90033, USA. thordars@usc.edu
Background:
Treatment of certain complex ankle pathology, such as a talar body fracture or osteochondral lesion requiring grafting, can necessitate medial malleolar osteotomy for adequate operative exposure. This paper evaluates the step-cut medial malleolar osteotomy for exposure of the ankle joint.
Method:
Fourteen patients with intra-articular pathology, including talar body fractures or osteochondral lesions necessitating extensive intra-articular exposure had step-cut malleolar osteotomy. The average age of the patients was 37 (range 20-90) years, and the average followup was 8 months.
Results:
All 14 patients had an uncomplicated intraoperative course, with excellent exposure of the ankle joint. All patients had prompt healing of the osteotomy by 6 weeks after surgery without loss of reduction. None of the patients had pain at the osteotomy site.
Conclusions:
Step-cut medial malleolar osteotomy is an excellent, reproducible method for extensive exposure of the talar dome.
