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A Mouse Model of Ankle-Subtalar Complex Joint Instability
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Ankle Mortise Instability in Multiple Hereditary Exostoses.

M Pierce Ebaugh1, Gregory Grenier2, Satbir Singh3

  • 1Jewett Orthopedic Institute at Orlando Health, Orlando, FL.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|April 4, 2022
PubMed
Summary
This summary is machine-generated.

Multiple hereditary exostoses (MHE) can cause ankle valgus and mortise widening. Surgical correction showed modest improvements in ankle angles, with limited impact on stability and function in MHE patients.

Keywords:
instabilityosteochondromavalgus

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Area of Science:

  • Orthopedics
  • Genetics
  • Radiology

Background:

  • Multiple hereditary exostoses (MHE) is a genetic disorder characterized by the development of multiple bony outgrowths.
  • Ankle valgus and mortise widening are common skeletal abnormalities associated with MHE, potentially leading to pain and functional limitations.

Purpose of the Study:

  • To characterize mortise widening in MHE patients.
  • To evaluate the progression of ankle deformities over time.
  • To assess the outcomes of surgical interventions on ankle pain and function at skeletal maturity.

Main Methods:

  • Retrospective review of 16 patients (19 ankles) with MHE and mortise widening.
  • Radiographic measurements (medial space, talocrural angle, tibiotalar angle) preoperatively and at follow-up.
  • Analysis of operative data, complications, and patient-reported outcomes (AOFAS, SF-36 scores).

Main Results:

  • 15 ankles (78.9%) presented with clinical valgus; 11 (57.9%) were painful preoperatively.
  • Surgical intervention, primarily medial distal tibia hemiepiphysiodesis, resulted in modest improvements in mortise medial space and tibiotalar angle, but angles did not normalize.
  • Talocrural angle remained within normal limits, but indicated fibular shortening and potential for talar shift, impacting ankle stability.

Conclusions:

  • Surgical correction for MHE-related ankle valgus and mortise widening yields modest radiographic improvements.
  • The achieved correction may be insufficient to restore full ankle stability and function.
  • Further research is needed to optimize treatment strategies for MHE-associated ankle deformities.