Figure 4 Very satisfactory radiological result after supramalleolar osteotomy and concomitant anterior ankle decompression: (a) standing preoperative radiograph showing varus deformity (abnormal TAS, TC, and MA angles) with asymmetrical joint space (abnormal TT angle) and impinging bony hump. (b) Immediate postoperative. Anteroposterior (AP) view radiograph (in cast) showing accepted correction with improved TAS, TC, TT, and MA angles with changed attitude of the distal segment of the fibula in relation to the proximal segment after partial fibulectomy and corrective medial opening-wedge osteotomy. (c) Immediate postoperative Mortis view radiograph (in cast) showing improved attitude after corrective osteotomy (done below the tibiofibular bony synostosis) with the graft keeping the osteotomy open. (d) 3 weeks postoperative Mortis view radiograph (after cast removal) showing good fixation, improved ankle attitude with symmetrical joint space, and the graft in place with no early collapse. (e) 3-year follow-up showing complete graft intake and remodeling with preserved, symmetrical joint space and very satisfactory alignment. (f) 8-year follow-up AP, lateral and different degrees of internal rotation views, radiographs showing very satisfactory radiological result (apart from small anterior hump) regarding alignment, joint preservation, and completely consolidated osteotomy site. MA, malalignment; TAS, tibial articular surface; TC, tibiocrural; TT, talar tilt.