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Dr.Tiwari
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Sustained tibia/fibula closed segmental fractures in 1983 resulting

Customer Question

Sustained tibia/fibula closed segmental fractures in 1983 resulting in varus deformity of tibia and 1 1/2" length discrepancy. Now suffering from advanced degenerative arthritis in ankle and knee and moderate in hip. Had osteotomy in 2008 to correct varus deformity but since have been diagnosed with rotatonal deformity that has caused increased pain in both knee and ankle.
Additionally,pain in lateral fibula from ostectomy resulting in diasastis. Recommended for knee anthroplasty and ankle arthrodesis. Questions: Which should be done first ? Does it matter? Can rotation be corrected with those surgeries? How and if not how can it be?
What can be done about the fibula?
Submitted: 5 years ago.
Category: Health
Expert:  Dr.Tiwari replied 5 years ago.
Hello,
You should go first for the ankle arthrodesis as after the TKR you have to go for mobility exrcises & then walking while after the arthrodesis procedure you have to go for a long rest of about 6-8 weeks to help with healing of the arthrodesis.Also after TKR if you decide to long rest due to arthrodesis then there are increase chances of complication like that of the DVT,REFLEX SYMPATHETIC DYSTROPHY & others.,Ankle arthrodesis does changes the normal biomechanical axis of walking ,after arthrodesis you can have TKR with all adjustment done according to your arthrodesis which can be done once the TKR is done before the arthrodesis.

You have your rotational deformity below the knee area so in TKR the deformity can not be corrected neither with arthrodesis of ankle it can be corrected by using the recent methods of the illizarov or ring fixators.

If diastasis at the febula is causing problem then it can be fixed with titanium plates with use of the graft from pelvic area.

Hope this will be helpful.

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Dr.Tiwari
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