Screw distraction technique for gaining fibular length

Shortening of fibular length is most commonly secondary to fracture, especially in cases of malreduction, malunion or nonunion. In the presence of deltoid ligament incompetence, a shortened fibula causes lateral talar shift, widening of the mortise, decreased tibiotalar contact area and increased incidence of post-traumatic arthrosis. Restoring fibular length is important for normal anatomic relationships and kinematics of the ankle joint. While several techniques have been described for restoring length, some limitations exist. We describe an alternative surgical technique that is straightforward and reproducible that allows for restoration of fibular length and rotation.