Fibular Lengthening Using Distraction Osteogenesis for the Treatment of Fibular Malunion

The importance of fibular reduction in the treatment of ankle fractures has been well described. The lateral malleolus is an important structure that contributes to ankle stability by maintaining the talus in proper anatomical position. Shortening and rotational malunion of the fibula can result after operative or nonoperative treatment. The resulting lateral talar tilt often results in chronic pain, swelling, and instability. Failure to adequately treat the deformity often leads to degenerative arthritis. Many techniques have been described to restore fibular alignment, including osteotomies with or without bone graft and internal or external fixation. In this case report, we describe a novel technique using a uniplanar external fixator and distraction osteogenesis to correct a fibular malunion.