Valgus deformity of the ankle in myelodysplastic patients. Correction by stapling of the medial part of the distal tibial physis.

Abstract

Thirteen patients with myelodysplasia and associated valgus deformities of the ankle had stapling of the medial part of the distal tibial physis. The pattern of neural involvement in these patients was responsible for characteristic muscle imbalances across the tibiotalar and subtalar joints which led to the valgus deformities. Stapling was performed in twenty-five ankles, fifteen of which had previously been treated unsuccessfully with various soft-tissue and bone procedures. Twelve of the patients were followed until closure of the physis. The average preoperative valgus deformity at the tibiotalar joint was 10 degrees and the average amount of correction was 16 degrees. There were no major complications in our series. All patients retained the ability to walk postoperatively, and there was no increase in the need for bracing. Stapling of the medial part of the distal tibial epiphysis has proved to be a safe and simple procedure for correction of valgus deformities of the ankle in myelodysplastic patients.