Malunions of the Distal Tibia and Ankle

Malunions about the ankle are a challenging clinical problem, as normal gait is dependent on the intact structure and function of the ankle joint. Malunions of the articular surface are at risk for arthritis, while those of the malleoli can affect joint stability. Similarly, malunions of the distal tibial metaphysis alter the mechanical axis of the limb and the orientation of adjacent joints. There is no one implant or procedure to treat ankle malunions. Instead, management of this problem requires the application of specific treatment principles and an understanding of each patient’s deformity. This chapter will review the evaluation of malunions with specific discussion of the ankle joint and distal tibia.