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. 2022 Jan:90:106677.
doi: 10.1016/j.ijscr.2021.106677. Epub 2021 Dec 8.

Reconstruction of traumatic medial malleolus loss using the bone sliding technique: A case report

Danlei Huang  1 , Jun Wang  1 , Zhiyang Ye  1 , Haoyuan Liu  1 , Jianming Huang  2
Affiliations

Reconstruction of traumatic medial malleolus loss using the bone sliding technique: A case report

Danlei Huang et al. Int J Surg Case Rep. 2022 Jan.

Abstract

Introduction: Open injury of the medial malleolus is relatively rare, and it can cause instability of the ankle joint and affect the walking function of the lower extremity. We describe an original plan for the reconstruction of medial malleolus defects using the bone sliding technique and report as follows.

Case presentation: A 48-year-old female presented with an isolated open injury to her right ankle by a traffic accident. The skin of the medial ankle was severely contaminated with mud, and the medial malleolus, part of the Talus's cartilage and soft tissue, were defective. The anterior tibial artery was cut, and the anterior and posterior tibial tendons were ruptured.

Conclusion: We describe the reconstruction of the medial malleolus using a bone sliding technique. At two years follow-up, she had a good outcome with a nearly painless, stable ankle with functional plantarflexion but restricted dorsiflexion. The original method is a new choice for the reconstruction of the medial malleolus.

Keywords: Ankle reconstruction; Bone sliding technique; Case report; Joint stability; Medial malleolus loss; Walking function.

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Conflict of interest statement

The authors declare that there is no conflict of interest in the publication of this paper.

Figures

Fig. 1
Fig. 1
The skin of medial ankle was severe contaminated with mud, and the skin cover was acceptable.
Fig. 2
Fig. 2
The medial malleolus, Part of the Talus's cartilage and soft tissue were defect. The anterior tibial artery was cut, and the anterior and posterior tibial tendons were ruptured.
Fig. 3-4
Fig. 3-4
Pre-operation X ray with loss of medial malleolus.
Fig. 5
Fig. 5
The periosteum was cut 2.5 ∗ 6 cm in size.
Fig. 6
Fig. 6
The size of bone block was made about 2.5 ∗ 6 ∗ 1 cm.
Fig. 7
Fig. 7
The distal end of the bone block was modified to simulating the shape of the medial malleolus, and the periosteum was transplanted to cover 2 cm distal end of the bone block to simulate the medial malleolus cartilage.
Fig. 8
Fig. 8
The periosteum was transplanted to cover the cartilage defects of the talus.
Fig. 9
Fig. 9
The bone block was sliding to the distal end of the tibia to reconstruct the medial malleolus and fixed with 2 cannulated screws.
Fig. 10-11
Fig. 10-11
The radiographs from 6-month follow-up showed consolidation of the sliding bone block.
See this image and copyright information in PMC

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