The effects of tibial malrotation on the biomechanics of the tibiotalar joint were studied using a cadaveric model loaded in an Instron 8521 materials testing device and a TEKScan I-Scan thin-film resistive ink pressure measuring system. Testing of 23 legs was performed using rotational conditions of 10 and 20° internal and external rotation as well as neutral rotation. All rotational conditions were found to decrease joint contact area. Peak pressures were significantly greater with 20° internal rotation as well as 20° external rotation. Total load across the joint was significantly lower for both 10 and 20° of external rotation. In conclusion, rotational deformity across the tibiotalar joint results in significant alteration of overall joint biomechanics and should be minimized whenever possible.
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