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Tibial rotational osteotomy

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By David Bennett Pediatric Orthopaedic Surgeon in the United States
Khaled M Emara, Ramy Ahmed Diab, Sherif El Ghazali, Amr Farouk, Mohamed Ahmed El Kersh
Lengthening the tibia more than 25% of its original length can be indicated for proximal femoral deficiency, poliomyelitis, or femoral infected nonunion. Such lengthening of the tibia can adversely affect the ankle or foot shape and function. The present study aimed to assess the effect of tibial lengthening of more than 25% of its original length on the foot and ankle shape and function compared with the preoperative condition. This was a retrospective study of 13 children with severe proximal focal femoral deficiency, Aitken classification type D, who had undergone limb lengthening from June 2000 to June 2008 using Ilizarov external fixators...
January 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
T F Kling, R N Hensinger
Angular and torsional malalignments of the lower extremity in children are common problems for which parents seek orthopedic advice. Calcaneal valgus of the foot, internal tibial torsion, genu varus, genu valgus, and femoral anteversion are normally observed in infants and usually are corrected with growth. The majority of angular deformities are physiologic; however, it is important to distinguish those requiring further evaluation and treatment. Accurate examination and knowledge of the natural history of rotational and angular deformities allow accurate assessment of the child and sound advice to the parents...
June 1983: Clinical Orthopaedics and related Research
E D Delgado, P L Schoenecker, M M Rich, A M Capelli
Over a 7-year period (1984-1991), nine patients (aged 10-18 years) with 13 involved extremities were operatively treated for symptomatic severe torsional malalignment of the lower extremity and associated patellofemoral pathology. Physical examination and analysis of gait revealed severe rotational deformity characterized by excessive femoral anteversion and external tibial torsion. The cosmetic and functional pathologic effect of this torsional malalignment was centered about the knee joint. In all patients, conservative treatment, including therapy for muscle strengthening and nonsteroidal medication, was unsuccessful in alleviating suspected patellofemoral pain...
July 1996: Journal of Pediatric Orthopedics
Kouji Naruse, Ken Urabe, Shi-Xu Jiang, Kentaroo Uchida, Yusuke Kozai, Hiroaki Minehara, Yuko Mikuni-Takagaki, Isamu Kashima, Moritoshi Itoman
STR/ort mice develop a naturally occurring osteoarthritis (OA) of the knee joints. However, the evaluation of early OA changes has been difficult due to variability caused by gender, individual differences, and differences between the right and left lower limbs. The objective of this study was to analyze the variability of the early OA changes with age in STR/ort mice and to identify the cause of onset. A total of 115 STR/OrtCrlj mice aged 10-45 weeks were examined. In addition to conventional radiological and histological evaluation of the knee joints, histological sections were used to examine the patellofemoral, femorotibial, and growth plate cartilage under similar conditions...
2009: Connective Tissue Research
Sang Hyeong Lee, Chin Youb Chung, Moon Seok Park, In Ho Choi, Tae-Joon Cho
UNLABELLED: Physical examinations of tibial torsion are used for preoperative planning and to assess outcomes of tibial osteomy in patients with cerebral palsy (CP). The thigh-foot angle (TFA) and transmalleolar axis (TMA) are commonly used, and the second toe test recently was introduced. However, the validity and reliability of the three methods have not been clarified. This study was performed to evaluate the validity and reliability of these physical measures. We recruited 18 patients (36 limbs) with CP...
August 2009: Clinical Orthopaedics and related Research
Jennifer Hicks, Allison Arnold, Frank Anderson, Michael Schwartz, Scott Delp
Excessive tibial torsion, a rotational deformity about the long axis of the tibia, is common in patients with cerebral palsy who walk with a crouch gait. Previous research suggests that this deformity may contribute to crouch gait by reducing the capacity of soleus to extend the knee; however, the effects of excess external torsion on the capacity of other muscles to extend the stance limb during walking are unknown. A computer model of the musculoskeletal system was developed to simulate a range of tibial torsion deformities...
October 2007: Gait & Posture
Hasan Bombaci, Gamze Kiliçoğlu, Gökhan Onur, Serhat Yanik, Mücahit Görgeç
OBJECTIVE: The purpose of this study was to evaluate the relationship between torsional variations of the lower extremity and the development of medial osteoarthritis in the knee. METHODS: Computed tomography measurements of the femoral and tibial torsion were evaluated in 21 lower extremities of 19 patients with primary bilateral gonarthrosis and compared with 14 lower extremities of eight normal individuals. RESULTS: There was no statistically significant difference between lower extremities with and without gonarthrosis in terms of tibial torsion (26...
2012: Acta Orthopaedica et Traumatologica Turcica
Atsushi Takahashi, Toshimi Aizawa, Takashi Aki, Mitsuhiro Kashiwaba, Masayuki Kamimura, Shin Hitachi, Eiji Itoi
PURPOSE: The fibular axis (FA) and anterior tibial cortex (ATC) are good determinants of the sagittal mechanical axis (MA) of lower legs during total knee arthroplasty (TKA).When compared with healthy subjects, a significant medial tibial torsion has been reported in patients with medial knee osteoarthritis; this should affect the alignment of lower legs. The purpose of this study was to clarify the effect of the medial torsion on relationship between sagittal MA and intraoperative references (FA and ATC)...
April 2013: Surgical and Radiologic Anatomy: SRA
Christof Radler, Andreas Kranzl, Hans Michael Manner, Michaela Höglinger, Rudolf Ganger, Franz Grill
Measurements of femoral and tibial torsion obtained from radiographs or computed tomographic scans have been used to describe rotational malalignment of the lower extremities and to clarify indications for surgery. A weak relationship between anatomic torsion deformity and the resulting transverse plane gait pattern in patients with cerebral palsy has been described, but the observations have not yet been tested in an able-bodied patient population. We conducted a prospective study to investigate the correlation of femoral torsion and tibial torsion as measured by using computed tomography with transverse plane gait data for patients with rotational malalignment...
July 2010: Gait & Posture
Benoit Theriault, Alexis F Turgeon, Stéphane Pelet
BACKGROUND: Tibial malrotation is a complication that is seen in approximately 30% of patients following locked intramedullary nailing. In this cohort study, we evaluated the hypothesis that tibial malrotation would lead to impaired functional outcomes. METHODS: Patients with a unilateral tibial shaft fracture who were managed with intramedullary nailing between 2003 and 2007 were identified with use of ICD-10 (International Classification of Diseases, 10th Revision) codes...
November 21, 2012: Journal of Bone and Joint Surgery. American Volume
U Sayli, S Bölükbasi, O S Atik, S Gündogdu
Torsional malalignment of the lower extremity, especially during childhood, is a common concern and even an anxiety to the parents. Torsional deformity may be seen at one or more sites, and tibial torsion is a frequent cause of this problem. Medial femoral torsion and metatarsus adductus also affects the alignment of the extremity. Although a corrective osteotomy for tibial torsion is performed very rarely, the precise determination is mandatory. Tibial torsion and the torsion of the leg was measured in 25 adults by computed tomography...
March 1994: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kyoung Min Lee, Chin Youb Chung, Ki Hyuk Sung, Tae Won Kim, Seung Yeol Lee, Moon Seok Park
BACKGROUND: The relationship between torsional bony deformities and rotational gait parameters has not been sufficiently investigated. This study was to investigate the degree of contribution of torsional bony deformities to rotational gait parameters in patients with diplegic cerebral palsy (CP). METHODS: Thirty three legs from 33 consecutive ambulatory patients (average age 9.5 years, SD 6.9 years; 20 males and 13 females) with diplegic CP who underwent preoperative three dimensional gait analysis, foot radiographs, and computed tomography (CT) were included...
June 15, 2013: Journal of Neuroengineering and Rehabilitation
James Karl Koenig, Maya E Pring, Jerry R Dwek
Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT...
January 2012: Pediatric Radiology
E Charki, D Pilliard, G Taussig
We have performed 32 supramalleolar osteotomies described by Mc Nicol to correct excessive internal or external tibial torsion in 22 patients (aged from 4 to 8 years, with different indications, with a follow-up of 16 months to 7 years). The consolidation of the osteotomy was obtained in 6 weeks. Eighteen patients (27 osteotomy) have a good result, 2 results are fair and 2 patients have a poor result. The indications for correction of excessive internal or external tibial torsion are very uncommon, and reserved to cases with functional disorbility of fitting appliances, or unaesthetic or uncomfortable gait...
1992: Annales de Chirurgie
S D Dzakhov, Iu V Kurochkin
No abstract text is available yet for this article.
December 1966: Ortopediia Travmatologiia i Protezirovanie
P Selber, E R Filho, R Dallalana, M Pirpiris, G R Nattrass, H K Graham
Torsional deformities of the tibia are common in children, but in the majority both the torsion and the associated disturbance of gait resolve without intervention. There are, however, a significant number of children and adults with neuromuscular disease who present with pathological tibial torsion, which may require surgical correction. We conducted a prospective study in two centres, to investigate the outcome of supramalleolar derotation osteotomy of the tibia, using internal fixation with the AO-ASIF T plate...
November 2004: Journal of Bone and Joint Surgery. British Volume
Nicholas Savva, Rangaraju Ramesh, Robert H Richards
Surgical correction of unilateral torsional deformity of the tibia is indicated in fewer than 1% of cases. Treatment is limited to those who have a progressive deformity, who are symptomatic and on whom conservative treatment has failed. We present the results of an osteotomy performed at the supramalleolar level leaving the fibula intact and held with staples. In 7 years, 13 children with a mean age of 13.4 years (range 10-16 years) underwent osteotomy. Six osteotomies were performed for internal tibial torsion (mean 25 degrees) and seven for external tibial torsion (mean 25 degrees)...
May 2006: Journal of Pediatric Orthopedics. Part B
D McNicol, J C Leong, L C Hsu
The development of lateral tibial torsion in the paralysed lower limb is well documented, but its pathogenesis is poorly understood. This paper attempts to provide an explanation for its development when it is associated with a varus or equinovarus deformity of the hindfoot. Correction of the lateral tibial torsion by supramalleolar derotation tibial osteotomy and reorientation of the ankle mortise appear to unlock the talus from the laterally rotated position, correcting a mobile hindfoot varus deformity and altering soft-tissue tensions about the ankle so that the correction achieved is maintained...
March 1983: Journal of Bone and Joint Surgery. British Volume
Adam S Becker, Mark S Myerson
The supramalleolar osteotomy is a commonly used surgical procedure to correct congenital or acquired deformities of the distal tibia, ankle, or foot. In children, osteotomy has been used to correct malunion of fractures, physeal growth arrest, tibial torsion, paralytic deformities, and sequelae of a clubfoot.
September 2009: Foot and Ankle Clinics
M Inan, F Ferri-de Baros, G Chan, K Dabney, F Miller
A percutaneous supramalleolar osteotomy with multiple drill holes and closed osteoclasis was used to correct rotational deformities of the tibia in patients with cerebral palsy. The technique is described and the results in 247 limbs (160 patients) are reported. The mean age at the time of surgery was 10.7 years (4 to 20). The radiographs were analysed for time to union, loss of correction, and angulation at the site of the osteotomy. Bone healing was obtained in all patients except one in a mean period of seven weeks (5 to 12)...
October 2005: Journal of Bone and Joint Surgery. British Volume
2014-10-04 19:24:27
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