Which supramalleolar osteotomy is most often used to correct a valgus ankle?

• A. Medial Closing Wedge
• B. Lateral Closing Wedge
• C. Medial Opening Wedge
• D. Posterior Closing Wedge

Answer: (A)

The key idea is how the direction of the wedge in a supramalleolar osteotomy changes the tilt of the distal tibia relative to the shaft, thereby realigning the ankle joint in the coronal plane. A valgus ankle has the distal tibial plafond tilted outward (toward the lateral side). To correct this, you want to tilt the plafond inward (toward varus) relative to the tibia.

A medial closing wedge accomplishes this correction by removing bone on the medial side and bringing the cut surfaces together. This action effectively realigns the distal fragment to tilt into varus, realigning the tibial plafond with the talus and reducing the valgus deformity. In practice, this approach directly creates the varus correction needed for a valgus ankle.

Other options would either open medially (which tends to increase valgus), or involve the lateral side or the posterior plane in ways that do not produce the desired coronal-plane correction for a valgus ankle. That's why the medial closing wedge is the most appropriate and commonly used choice for correcting valgus alignment.