Medial Malleolar Osteotomies for Varus Correction During Total Ankle Replacement

Medial malleolar osteotomy is a valuable but underutilized technique for correcting significant varus deformity in total ankle replacement (TAR). While soft tissue balancing is often sufficient, excessive varus may necessitate osseous correction to restore neutral alignment. This article reviews the etiology, indications, surgical techniques, and outcomes of medial malleolar osteotomy use in TAR, emphasizing a staged approach to optimize healing and implant stability. Proper deformity assessment and individualized patient treatment plans are essential to prevent early failure. Further research is needed to establish objective criteria for when medial malleolar osteotomy is preferable to soft tissue release alone.