〈 Evolving Techniques 〉 Lengthening z-Osteotomy of the Fibula to Correct Persistent Talar Shift Following Open Reduction Internal Fixation of Ankle Fractures

Background: In cases where ankle fracture union has been compro- mised by persistent syndesmotic dias- tasis following open reduction internal fixation, both external rotation and shortening of the fibula have been iden- tified as prominent features. Objective: This study reports a technique that uses a z-osteotomy to achieve both lengthen- ing and internal rotation of the fibula to correct persistent talar shift follow- ing ankle fracture fixation. Methods: Four patients with persistent talar shift following open reduction internal fix- ation for an ankle fracture received z-osteotomy of the fibula to achieve both lengthening and internal rotation. Results: At the latest clinic review, all 4 ankles exhibited satisfactory clinical and radiological union. All patients have returned to full mobility and are satisfied with the outcome. Conclusions: This study demonstrates the effective- ness of lengthening z-osteotomy of the fibula in correcting persistent talar shift following internal fixation of ankle fractures.