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.