{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:58:14Z","timestamp":1793836694637,"version":"4.6.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>This study aimed to investigate the early-to-mid-term efficacy of supramalleolar osteotomy (SMO) for the management of post-traumatic ankle arthritis resulting from previous fractures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective analysis was conducted on the clinical data of 19 individuals with post-traumatic ankle arthritis secondary to old fractures treated with SMO between March 2018 and September 2022. The cohort included 6 males and 13 females, aged 15 to 59 years, with an average of 37.1\u2009\u00b1\u200915.8 years. Among these cases, 12 underwent surgical treatment for their initial fractures, while 7 received conservative management. Clinical efficacy was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Foot Function Index (FFI), and Visual Analog Score (VAS) for pain. Imaging analyses were conducted using the changes of tibial anterior surface angle (TAS), talar tilt (TT) angle, and modified Takakura stage. Evaluation of patient satisfaction after surgery was conducted during the final follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>All patients were followed up for 12 to 47 months (mean follow-up: 21.9\u2009\u00b1\u200911.1 months). At the final follow-up, the AOFAS ankle-hindfoot score improved to 81.9\u2009\u00b1\u20099.8, the FFI decreased to 24.2\u2009\u00b1\u200922.8, and the VAS score decreased to 3.2\u2009\u00b1\u20093.0, all showing significant improvement compared with preoperative values (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The TAS angle increased significantly to 90.2\u00b0 \u00b1 5.1\u00b0 postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), while the TT angle was 0.3\u00b0 \u00b1 2.5\u00b0, without a statistically significant change (<jats:italic>p<\/jats:italic>\u2009=\u20090.314). No significant progression was observed in the modified Takakura stage (<jats:italic>p<\/jats:italic>\u2009=\u20090.458). The overall patient satisfaction rate was 89.5% (17\/19). Prognostic analysis revealed no correlation between fracture-to-surgery interval (1\u201327 years) and AOFAS improvement ( <jats:italic>r<\/jats:italic>\u2009=\u20090.233, <jats:italic>p<\/jats:italic>\u2009=\u20090.337). Excessive preoperative TT (&gt;\u20097.3\u00b0) did not compromise outcomes after correction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>SMO demonstrates favorable early-to-mid-term efficacy in the treatment of traumatic fracture-related ankle arthritis, with significant improvements in pain relief, functional scores, and patient satisfaction. Prognostic factors (time since fracture, severe talar tilt) did not adversely affect results, supporting SMO\u2019s utility across diverse presentations.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12893-025-03087-1","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T09:12:37Z","timestamp":1754903557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Supramalleolar osteotomy outcomes for post-traumatic fracture-related ankle arthritis: a retrospective analysis"],"prefix":"10.1186","volume":"25","author":[{"given":"Yun-Qing","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Wen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Feng","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"issue":"3","key":"3087_CR1","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1002\/jor.23462","volume":"35","author":"ML Delco","year":"2017","unstructured":"Delco ML, Kennedy JG, Bonassar LJ, Fortier LA. Post-traumatic osteoarthritis of the ankle: A distinct clinical entity requiring new research approaches. J Orthop Res. 2017;35(3):440\u201353. https:\/\/doi.org\/10.1002\/jor.23462.","journal-title":"J Orthop Res"},{"issue":"4","key":"3087_CR2","doi-asserted-by":"publisher","first-page":"220","DOI":"10.5435\/00124635-200904000-00003","volume":"17","author":"A Chu","year":"2009","unstructured":"Chu A, Weiner L. Distal fibula malunions. J Am Acad Orthop Surg. 2009;17(4):220\u201330. https:\/\/doi.org\/10.5435\/00124635-200904000-00003.","journal-title":"J Am Acad Orthop Surg"},{"issue":"1","key":"3087_CR3","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1186\/s12891-022-06008-y","volume":"23","author":"HJ Wu","year":"2022","unstructured":"Wu HJ, He YX, Hang C, Hao L, Lin TK. AO distractor and manual traction reduction techniques repair in distal tibial fractures: a comparative study. BMC Musculoskelet Disord. 2022;23(1):1081. https:\/\/doi.org\/10.1186\/s12891-022-06008-y. Published 2022 Dec 12.","journal-title":"BMC Musculoskelet Disord"},{"issue":"10","key":"3087_CR4","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1177\/1071100718795630","volume":"39","author":"AC Egger","year":"2018","unstructured":"Egger AC, Berkowitz MJ. Operative treatment of the malunited fibula fracture. Foot Ankle Int. 2018;39(10):1242\u201352. https:\/\/doi.org\/10.1177\/1071100718795630.","journal-title":"Foot Ankle Int"},{"issue":"7","key":"3087_CR5","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1530\/EOR-21-0117","volume":"7","author":"M Herrera-P\u00e9rez","year":"2022","unstructured":"Herrera-P\u00e9rez M, Valderrabano V, Godoy-Santos AL, de C\u00e9sar Netto C, Gonz\u00e1lez-Mart\u00edn D, Tejero S. Ankle osteoarthritis: comprehensive review and treatment algorithm proposal. EFORT Open Rev. 2022;7(7):448\u201359. https:\/\/doi.org\/10.1530\/EOR-21-0117. Published 2022 Jul 5.","journal-title":"EFORT Open Rev"},{"issue":"1","key":"3087_CR6","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/S0891-8422(23)00222-7","volume":"4","author":"SJ Devalentine","year":"1987","unstructured":"Devalentine SJ. Epiphyseal injuries of the foot and ankle. Clin Podiatr Med Surg. 1987;4(1):279\u2013310.","journal-title":"Clin Podiatr Med Surg"},{"issue":"1","key":"3087_CR7","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.fcl.2015.09.003","volume":"21","author":"D Weber","year":"2016","unstructured":"Weber D, Weber M. Corrective osteotomies for malunited malleolar fractures. Foot Ankle Clin. 2016;21(1):37\u201348. https:\/\/doi.org\/10.1016\/j.fcl.2015.09.003.","journal-title":"Foot Ankle Clin"},{"issue":"10","key":"3087_CR8","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1302\/0301-620X.93B10.26944","volume":"93","author":"B Hintermann","year":"2011","unstructured":"Hintermann B, Barg A, Knupp M. Corrective supramalleolar osteotomy for malunited pronation-external rotation fractures of the ankle. J Bone Joint Surg Br. 2011;93(10):1367\u201372. https:\/\/doi.org\/10.1302\/0301-620X.93B10.26944.","journal-title":"J Bone Joint Surg Br"},{"issue":"9","key":"3087_CR9","doi-asserted-by":"publisher","first-page":"5549","DOI":"10.1007\/s00402-023-04867-1","volume":"143","author":"P Christidis","year":"2023","unstructured":"Christidis P, Lampridis V, Kalitsis C, Kantas T, Biniaris G, Gougoulias N. Supramalleolar osteotomies for ankle arthritis: a systematic review. Arch Orthop Trauma Surg. 2023;143(9):5549\u201364. https:\/\/doi.org\/10.1007\/s00402-023-04867-1.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"4","key":"3087_CR10","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.cpm.2023.05.017","volume":"40","author":"S Mateen","year":"2023","unstructured":"Mateen S, Siddiqui NA. The role of supramalleolar osteotomies in ankle arthritis. Clin Podiatr Med Surg. 2023;40(4):769\u201381. https:\/\/doi.org\/10.1016\/j.cpm.2023.05.017.","journal-title":"Clin Podiatr Med Surg"},{"issue":"4","key":"3087_CR11","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.cpm.2012.07.002","volume":"29","author":"NA Siddiqui","year":"2012","unstructured":"Siddiqui NA, Herzenberg JE, Lamm BM. Supramalleolar osteotomy for realignment of the ankle joint. Clin Podiatr Med Surg. 2012;29(4):465\u201382. https:\/\/doi.org\/10.1016\/j.cpm.2012.07.002.","journal-title":"Clin Podiatr Med Surg"},{"issue":"9","key":"3087_CR12","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1177\/1071100717712543","volume":"38","author":"B Hintermann","year":"2017","unstructured":"Hintermann B, Ruiz R, Barg A. Novel double osteotomy technique of distal tibia for correction of asymmetric varus Osteoarthritic ankle. Foot Ankle Int. 2017;38(9):970\u201381. https:\/\/doi.org\/10.1177\/1071100717712543.","journal-title":"Foot Ankle Int"},{"issue":"1","key":"3087_CR13","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12891-016-1367-2","volume":"18","author":"X Li","year":"2017","unstructured":"Li X, Zhu Y, Xu Y, Wang B, Liu J, Xu X. Osteochondral autograft transplantation with biplanar distal tibial osteotomy for patients with concomitant large osteochondral lesion of the talus and varus ankle malalignment. BMC Musculoskelet Disord. 2017;18(1):23. https:\/\/doi.org\/10.1186\/s12891-016-1367-2. Published 2017 Jan 19.","journal-title":"BMC Musculoskelet Disord"},{"issue":"5","key":"3087_CR14","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1053\/j.jfas.2014.12.042","volume":"54","author":"B Bloch","year":"2015","unstructured":"Bloch B, Srinivasan S, Mangwani J. Current concepts in the management of ankle osteoarthritis: A systematic review. J Foot Ankle Surg. 2015;54(5):932\u20139. https:\/\/doi.org\/10.1053\/j.jfas.2014.12.042.","journal-title":"J Foot Ankle Surg"},{"issue":"4","key":"3087_CR15","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/s12178-014-9231-1","volume":"7","author":"A Barg","year":"2014","unstructured":"Barg A, Saltzman CL. Single-stage supramalleolar osteotomy for coronal plane deformity. Curr Rev Musculoskelet Med. 2014;7(4):277\u201391. https:\/\/doi.org\/10.1007\/s12178-014-9231-1.","journal-title":"Curr Rev Musculoskelet Med"},{"key":"3087_CR16","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1097\/BLO.0b013e318124a462","volume":"462","author":"GI Pagenstert","year":"2007","unstructured":"Pagenstert GI, Hintermann B, Barg A, Leumann A, Valderrabano V. Realignment surgery as alternative treatment of varus and valgus ankle osteoarthritis. Clin Orthop Relat Res. 2007;462:156\u201368. https:\/\/doi.org\/10.1097\/BLO.0b013e318124a462.","journal-title":"Clin Orthop Relat Res"},{"issue":"7","key":"3087_CR17","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1302\/0301-620X.88B7.17325","volume":"88","author":"Y Tanaka","year":"2006","unstructured":"Tanaka Y, Takakura Y, Hayashi K, Taniguchi A, Kumai T, Sugimoto K. Low tibial osteotomy for varus-type osteoarthritis of the ankle. J Bone Joint Surg Br. 2006;88(7):909\u201313. https:\/\/doi.org\/10.1302\/0301-620X.88B7.17325.","journal-title":"J Bone Joint Surg Br"},{"issue":"7","key":"3087_CR18","first-page":"776","volume":"37","author":"XW Wang","year":"2023","unstructured":"Wang XW, Li H, Gong XF, et al. Early efficacy of a new minimally invasive plate in the treatment of valgus ankle arthritis. Chin J Reparative Reconstr Surg. 2023;37(7):776\u201381.","journal-title":"Chin J Reparative Reconstr Surg"},{"issue":"13","key":"3087_CR19","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.2106\/JBJS.J.00249","volume":"93","author":"WC Lee","year":"2011","unstructured":"Lee WC, Moon JS, Lee K, Byun WJ, Lee SH. Indications for supramalleolar osteotomy in patients with ankle osteoarthritis and varus deformity. J Bone Joint Surg Am. 2011;93(13):1243\u20138. https:\/\/doi.org\/10.2106\/JBJS.J.00249.","journal-title":"J Bone Joint Surg Am"},{"issue":"3","key":"3087_CR20","doi-asserted-by":"publisher","first-page":"271","DOI":"10.4055\/cios20038","volume":"12","author":"JB Lacorda","year":"2020","unstructured":"Lacorda JB, Jung HG, Im JM. Supramalleolar distal tibiofibular osteotomy for medial ankle osteoarthritis: current concepts. Clin Orthop Surg. 2020;12(3):271\u20138. https:\/\/doi.org\/10.4055\/cios20038.","journal-title":"Clin Orthop Surg"},{"issue":"2","key":"3087_CR21","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1177\/1071100716673416","volume":"38","author":"N Kr\u00e4henb\u00fchl","year":"2017","unstructured":"Kr\u00e4henb\u00fchl N, Zwicky L, Bolliger L, Sch\u00e4delin S, Hintermann B, Knupp M. Mid- to Long-term results of supramalleolar osteotomy. Foot Ankle Int. 2017;38(2):124\u201332. https:\/\/doi.org\/10.1177\/1071100716673416.","journal-title":"Foot Ankle Int"},{"issue":"2","key":"3087_CR22","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1007\/s00167-022-07144-7","volume":"31","author":"JJ Butler","year":"2023","unstructured":"Butler JJ, Azam MT, Weiss MB, Kennedy JG, Walls RJ. Supramalleolar osteotomy for the treatment of ankle osteoarthritis leads to favourable outcomes and low complication rates at mid-term follow-up: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2023;31(2):701\u201315. https:\/\/doi.org\/10.1007\/s00167-022-07144-7.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"4","key":"3087_CR23","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.otsr.2013.12.027","volume":"100","author":"F Colin","year":"2014","unstructured":"Colin F, Gaudot F, Odri G, Judet T. Supramalleolar osteotomy: techniques, indications and outcomes in a series of 83 cases [published correction appears in Orthop Traumatol Surg Res. 2014 Sep;100(5):581]. Orthop Traumatol Surg Res. 2014;100(4):413\u20138. https:\/\/doi.org\/10.1016\/j.otsr.2013.12.027.","journal-title":"Orthop Traumatol Surg Res"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-025-03087-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-025-03087-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-025-03087-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T20:16:24Z","timestamp":1757362584000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcsurg.biomedcentral.com\/articles\/10.1186\/s12893-025-03087-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3087"],"URL":"https:\/\/doi.org\/10.1186\/s12893-025-03087-1","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]},"assertion":[{"value":"5 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki(as was revised in 2013). The study was approved by Ethics Committee of the Beijing Jishuitan Hospital (No: K2022-105-00) and waived the requirement for informed consent due to the retrospective nature of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}],"article-number":"366"}}