SUPRAMALLEOLAR OSTEOTOMY FOR ANKLE VALGUS IN MYELOMENINGOCELE

Fifty-five supramalleolar osteotomies were performed in 35 patients fo r progressive hindfoot valgus in myelomeningocele. All patients were a mbulatory. The most common motor level of innervation was L3 in 42 lim bs. The average age al surgery was 12 years. The average follow-up was 8 years, Preoperatively, all patients experienced progressive difficu lty with brace use, and anteroposterior weight-bearing angle radiograp hs showed a valgus tilt of the talotibial angle (TTA) of greater than or equal to 10 degrees with an average of 18 degrees. The average post operative correction of TTA was 17 degrees. The results were graded as follows: excellent, 42 limbs; good, eight limbs; fair, three limbs; a nd poor, two limbs. Tile fair and poor limb results were the result of loss of correction or nonunion. The best results were seen when the T TA was corrected to 5 degrees of varus.