Distal Tibial Metaphyseal Malunion Treated with Clamshell Osteotomy: A Case Report

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering

Background:

• Tibial malunions, particularly in the distal metaphysis, can lead to significant biomechanical alterations.
• These deformities increase joint reaction forces and negatively impact gait mechanics, patient satisfaction, and quality of life.

Observation:

• A 49-year-old female patient with hypertension and polysubstance use disorder presented with a distal tibial metaphyseal malunion.
• The patient underwent a clamshell osteotomy for correction of the malunion.

Findings:

• The clamshell osteotomy, a technique previously described for diaphyseal malunions, was successfully applied to a complex periarticular metaphyseal malunion.
• The patient experienced a 2.5-year follow-up period post-surgery.

Implications:

• Correction of tibial malunions through procedures like the clamshell osteotomy can enhance patient satisfaction and quality of life.
• Surgical intervention may reduce the risk of developing early-onset arthritis in affected joints.
• The clamshell osteotomy demonstrates versatility in treating complex metaphyseal malunions, expanding its clinical application.