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Case Reports
. 2022 Nov 21;14(11):e31755.
doi: 10.7759/cureus.31755. eCollection 2022 Nov.

Treatment of Open Traumatic Medial Malleolus Bone Loss With Osteochondral Allograft: A Case Report

Thomas B Anderson  1 , Andrew S Bae  1 , Jazmone Kelly  2 , David P Antekeier  3
Affiliations
Case Reports

Treatment of Open Traumatic Medial Malleolus Bone Loss With Osteochondral Allograft: A Case Report

Thomas B Anderson et al. Cureus. .

Abstract

Osteochondral damage to the ankle joint can be a difficult problem to manage in a young active patient. There are several described surgical treatments ranging from cartilage repair techniques to arthrodesis and ankle replacement. In this case, we present a 28-year-old male who sustained a right type IIIA open medial malleolus fracture following an all-terrain vehicle crash. After sharp debridement, the clinical decision was made to treat the patient with an osteochondral allograft. At one- and two-year post-allograft reconstruction, radiographs demonstrated good incorporation of the graft. The patient was ambulating with no pain or assistive devices. Our case report specifically describes the successful treatment of a traumatic medial malleolus ankle fracture with bone loss using an osteochondral allograft in a young active patient.

Keywords: ankle arthritis; ankle trauma; bone loss; fresh osteochondral allograft; medial malleolus; type iiia open medial malleolus fracture.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Right medial ankle wound with gross contamination.
Figure 2
Figure 2. Initial injury radiographs - AP, oblique, and lateral of ankle
AP: anteroposterior
Figure 3
Figure 3. Intraoperative media of medial malleolus bone loss.
Figure 4
Figure 4. Osteochondral tibia allograft sizing.
Figure 5
Figure 5. Medial malleolus osteochondral allograft with overlying hardware and tibialis anterior tendon allograft reconstruction.
Figure 6
Figure 6. Radiographs of the right ankle two weeks status post-allograft implantation with no interval displacement.
Figure 7
Figure 7. Radiographs of right ankle at year two post-allograft implant with good incorporation of graft.
See this image and copyright information in PMC

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