Foot

For fixation of fractures of the talus.

Curve the incision just proximal to the medial malleolus, and divide the malleolus with an osteotome; preserve the attachment of the deltoid ligament. Then subluxate the talus and malleolus laterally to reach the joint surfaces. Later replace the malleolus and fix it with a cancellous screw. To make replacement easier, drill the hole for the screw before osteotomy, insert the screw, and then remove it. At the end of the operation reinsert the screw and close the wound. The surfaces of the osteotomized bone are smooth, and the malleolus may rotate on a single screw; therefore the addition of one or two small threaded wires may be necessary to stabilize the fixation. Interfragmentary technique should be used for screw fixation of the medial malleolus to provide compression across the osteotomy site.

It may be useful for fracture-dislocations of the talus, other traumatic lesions of the ankle joint, and osteochondritis dissecans of the talus.