Effect of four combined procedures to achieve inframalleolar correction for advanced varus ankle arthritis.

A man in his early 60s with Takakura stage IIIB varus ankle arthritis underwent four combined procedures (Dwyer's osteotomy with lateral displacement, superficial/deep deltoid ligament release, anterior talofibular ligament/calcaneofibular ligament reconstruction with suture tape augmentation and posterior tibial tendon lengthening). Decreased talar tilt and talar centre lateral shifting and improved hindfoot varus were observed 2 years postoperatively. Also, excellent clinical outcome could be achieved.