Fibula Lengthening and Ankle Distraction for Post-Traumatic Ankle

The ankle is a highly constrained hinged joint composed of three articulations: the tibiotalar, fibulotalar, and tibiofibular joints. The distal tibia and fibula form the ankle mortise, with the trochlea of the talus acting as the keystone. Bony congruity of the ankle joint contributes to ankle containment and static stability. The fibula is an important lateral buttress for talar translation with widening of the mortise leading to significant decrease in tibiotalar joint reaction forces and ankle degeneration. Fibular malunion, mainly shortening, or malrotation have also been shown to increase tibiotalar joint reaction forces and lead to ankle joint degeneration.