Supramalleolar Tibial Osteotomy for the Prevention of Asymmetric Crus Arthrosis: A Case Report

Tazhin K. Nurakhmetov A. Askarov N. Kalzhanov A. Kossubayev A.
2025 Dove Medical Press Ltd

International Medical Case Reports Journal
2025 #18 1319 - 1328 pp.

Asymmetric ankle osteoarthritis, whether congenital or posttraumatic, develops from disruption of the mechanical axis and leads to progressive joint degeneration. Supramalleolar osteotomy (SMO) is a joint-preserving procedure that restores alignment and redistributes joint-loading forces. However, conventional fixation often involves bulky implants or external fixators, resulting in excessive surgical trauma, high metal consumption, and prolonged rehabilitation. The optimal fixation strategy for SMO remains a topic of debate. We present a 54-year-old woman with asymmetric ankle osteoarthritis and a 13-degree varus deformity of the tibia. The patient underwent a minimally invasive SMO stabilized with a customized low-profile titanium mini-plate. Postoperative radiographs confirmed restoration of the mechanical and anatomical tibial axes and correction of the varus deformity. At the 2-month follow-up, functional outcomes improved markedly. The AOFAS ankle-hindfoot score increased from 56 preoperatively to 86 postoperatively, the Visual Analog Scale (VAS) for pain decreased from 7/10 to 2/10, and the Foot and Ankle Disability Index (FADI) improved from 58% to 88%. No complications were observed. This case highlights the potential of a customized low-profile mini-plate to achieve stable fixation with minimal implant use and reduced surgical trauma. The approach allowed early mobilization, symptomatic relief, and functional recovery within a short follow-up period. Although the favorable short-term outcome supports the feasibility of this minimally invasive method, further studies with larger cohorts and longer follow-up are needed to validate its effectiveness and cost-efficiency compared with traditional fixation techniques.

congenital abnormalities , osteoarthritis, ankle , osteotomy, tibial , osteotomy, wedge , varus deformity

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Orthopedics Department No. 2, National Scientific Center of Traumatology and Orthopedics, Astana, Kazakhstan
Department of Traumatology and Orthopedics, Astana Medical University, Astana, Kazakhstan
Karaganda Medical University, Karaganda, Kazakhstan

Orthopedics Department No. 2
Department of Traumatology and Orthopedics
Karaganda Medical University

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