Percutaneous Supramalleolar Osteotomy Using the Ilizarov/Taylor Spatial Frame



The supramalleolar osteotomy (SMO) can be used to reposition the ankle and foot by correcting deformity about the ankle. Indications for this procedure include malunion of fracture, stiff nonunion, malunion of ankle fusion, arthrosis of the ankle with talar tilt, growth arrest deformity, and congenital or developmental deformity.1,2

The SMO can be performed in isolation or can be combined with other procedures such as ankle distraction, ankle fusion, or simultaneous lengthening. In general, SMO can be performed with acute or gradual correction, internal or external fixation, and closing, opening, or neutral wedge technique. While a mild to moderate valgus deformity of the ankle can be corrected with a traditional open surgery using a medial closing wedge technique, acute correction, and internal fixation, this technique has limitations and drawbacks. These include the need for open surgery and implantation of hardware, deformity correction limitations, and no postoperative adjustability.


Deformity Correction Varus Deformity Rotational Deformity Gradual Correction Ilizarov Method 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Pugh K, Rozbruch SR. Nonunions and malunions. In: Baumgaertner MR, Tornetta P (eds.) Orthopaedic Knowledge Update Trauma 3. Rosemont, IL: American Academy of Orthopaedic Surgeons, 2005, pp. 115–130Google Scholar
  2. 2.
    Stamatis ED, Myerson MS. Supramalleolar osteotomy: indications and technique. Foot Ankle Clin 2003; 8(2):317–333CrossRefPubMedGoogle Scholar
  3. 3.
    Graehl PM, Hersh MR, Heckman JD. Supramalleolar osteotomy for the treatment of symptomatic tibial malunion. J Orthop Trauma 1987; 1(4):281–292CrossRefPubMedGoogle Scholar
  4. 4.
    Paley D. Principles of Deformity Correction, 1st ed. Berlin: Springer, 2005Google Scholar
  5. 5.
    Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A. Deformity planning for frontal and sagittal plane corrective osteotomies. Orthop Clin North Am 1994; 25(3):425–465PubMedGoogle Scholar
  6. 6.
    Feldman DS, Shin SS, Madan S, Koval KJ. Correction of tibial malunion and nonunion with six-axis analysis deformity correction using the Taylor Spatial Frame. J Orthop Trauma 2003; 17(8):549–554CrossRefPubMedGoogle Scholar
  7. 7.
    Fragomen A, Ilizarov S, Blyakher A, Rozbruch SR. Proximal tibial osteotomy for medial compartment osteoarthritis of the knee using the Taylor Spatial Frame. Tech Knee Surg 2005; 4(3):175–183CrossRefGoogle Scholar
  8. 8.
    Rozbruch SR, Helfet DL, Blyakher A. Distraction of hypertrophic nonunion of tibia with deformity using Ilizarov/Taylor Spatial Frame. Report of two cases. Arch Orthop Trauma Surg 2002; 122(5):295–298CrossRefPubMedGoogle Scholar
  9. 9.
    Inda JI, Blyakher A, O’Malley MJ, Rozbruch SR. Distraction arthroplasty for the ankle using the Ilizarov Frame. Tech Foot Ankle Surg 2003; 2(4):249–253CrossRefGoogle Scholar
  10. 10.
    Rozbruch SR. Post-traumatic reconstruction of the ankle using the Ilizarov method. J Hosp Spec Surg 2005; 1:68–88Google Scholar
  11. 11.
    Shtarker H, Volpin G, Stolero J, Kaushansky A, Samchukov M. Correction of combined angular and rotational deformities by the Ilizarov method. Clin Orthop Relat Res 2002 Sep; (402):184–195CrossRefPubMedGoogle Scholar
  12. 12.
    Paley D. The correction of complex foot deformities using Ilizarov’s distraction osteotomies. Clin Orthop Relat Res 1993 Aug; (293):97–111PubMedGoogle Scholar
  13. 13.
    Pearce MS, Smith MA, Savidge GF. Supramalleolar tibial osteotomy for haemophilic arthropathy of the ankle. J Bone Joint Surg Br 1994; 76(6):947–950PubMedGoogle Scholar
  14. 14.
    Benthien RA, Myerson MS. Supramalleolar osteotomy for ankle deformity and arthritis. Foot Ankle Clin 2004; 9(3):475–487, viiiCrossRefPubMedGoogle Scholar
  15. 15.
    Stamatis ED, Cooper PS, Myerson MS. Supramalleolar osteotomy for the treatment of distal tibial angular deformities and arthritis of the ankle joint. Foot Ankle Int 2003; 24(10):754–764PubMedGoogle Scholar
  16. 16.
    Sen C, Kocaoglu M, Eralp L, Cinar M. Correction of ankle and hindfoot deformities by supramalleolar osteotomy. Foot Ankle Int 2003; 24(1):22–28PubMedGoogle Scholar
  17. 17.
    Fraser RK, Menelaus MB. The management of tibial torsion in patients with spina bifida. J Bone Joint Surg Br 1993; 75(3):495–497PubMedGoogle Scholar
  18. 18.
    Abraham E, Lubicky JP, Songer MN, Millar EA. Supramalleolar osteotomy for ankle valgus in myelomeningocele. J Pediatr Orthop 1996; 16(6):774–781PubMedGoogle Scholar
  19. 19.
    Selber P, Filho ER, Dallalana R, Pirpiris M, Nattrass GR, Graham HK. Supramalleolar derotation osteotomy of the tibia, with T plate fixation. Technique and results in patients with neuromuscular disease. J Bone Joint Surg Br 2004; 86(8):1170–1175CrossRefPubMedGoogle Scholar
  20. 20.
    Inan M, Ferri-de Baros F, Chan G, Dabney K, Miller F. Correction of rotational deformity of the tibia in cerebral palsy by percutaneous supramalleolar osteotomy. J Bone Joint Surg Br 2005; 87(10):1411–1415CrossRefPubMedGoogle Scholar
  21. 21.
    Rozbruch SR, Blyakher A, Haas SB, Hotchkiss R. Correction of large bilateral tibia vara with the Ilizarov method. J Knee Surg 2003; 16(1):34–37PubMedGoogle Scholar
  22. 22.
    Best A, Daniels TR. Supramalleolar tibial osteotomy secured with the Puddu plate. Orthopedics 2006; 29(6):537–540PubMedGoogle Scholar
  23. 23.
    Mangone PG. Distal tibial osteotomies for the treatment of foot and ankle disorders. Foot Ankle Clin 2001; 6(3):583–597CrossRefPubMedGoogle Scholar
  24. 24.
    Rozbruch SR, Weitzman AM, Watson JT, Freudigman P, Katz H, V, Ilizarov S. Simultaneous treatment of tibial bone and soft-tissue defects with the Ilizarov method. J Orthop Trauma 2006; 20(3):197–205Google Scholar
  25. 25.
    Ilizarov GA. Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res 1990 Jan; (250):8–26PubMedGoogle Scholar
  26. 26.
    Mendicino RW, Catanzariti AR, Reeves CL. Percutaneous supramalleolar osteotomy for distal tibial (near articular) ankle deformities. J Am Podiatr Med Assoc 2005; 95(1):72–84PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Limb Lengthening and Deformity ServiceHospital for Special SurgeryNew YorkUSA
  2. 2.Associate Professor of Clinical Orthopaedic SurgeryWeill Medical College of Cornell UniversityNew YorkUSA

Personalised recommendations