Distal tibial derotational osteotomy with external fixation to treat torsional deformities: a review of 71 cases

Erschbamer, Matthias; Gerhard, Pascal; Klima, Harry; Ellenrieder, B.; Zdenek-Lehnen, Katja; Giesinger, Karlmeinrad

doi:10.1097/bpb.0000000000000308

Cited by 16 publications

(10 citation statements)

References 23 publications

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“…The indications for the treatment of idiopathic torsion remain vague and include the presence of severe deformity $3 standard deviations from the mean, but functional pain and disability remain the primary considerations 105,122 . Osteotomy for the treatment of tibial torsion can restore kinetic and kinematic parameters of knee motion to nearnormal values 123 .…”

Section: Operative Considerationsmentioning

confidence: 99%

“…Osteotomy is performed proximally, distally, or in the midshaft and can be either percutaneous or open. Fixation can be performed with an intramedullary nail, staples, casting, plates, Kirschner wires, or an external fixator 90,119,122,[124][125][126][127][128][129] . Fibular osteotomy may be performed if the tibia derotation angle is .30°1 22 .…”

Section: Operative Considerationsmentioning

confidence: 99%

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Idiopathic Rotational Abnormalities of the Lower Extremities in Children and Adults

2019

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» Rotational malalignment of the lower extremity is a potential cause of hip, knee, and ankle pain. » Physical examination must include observation of gait and an assessment of femoral rotation and the thigh-foot axis with the patient prone. » Advanced imaging helps to quantify the degree of deformity, improving the accuracy of the preoperative plan. » Surgical correction of rotational malalignment of the femur and tibia is reserved for severe, symptomatic deformity. » Future software that allows for 3-dimensional assessment of alignment and preoperative planning will further aid in the correction of the complex deformities. Natural History An appreciation of the childhood rotational development pathway helps us to better understand associated deformity in adolescents and adults. Limb rotation starts in utero and is part of normal development. At 5 months, the normal fetus has about 20°of internal tibial torsion. At birth, many infants have internal tibial rotation (2°to 4°), increased femoral anteversion (;40°), and external contractures at the hip 3,10,17. These uterine molding effects typically Disclosure: No external funds were received in support of this study. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJSREV/A407).

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Section: Operative Considerationsmentioning

confidence: 99%

Section: Operative Considerationsmentioning

confidence: 99%

Idiopathic Rotational Abnormalities of the Lower Extremities in Children and Adults

2019

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“…Nine percent showed a loss of correction with the need of revision surgery and posterior bowing was detected in 19% of the cases. Erschbamer et al 35 were also using a percutaneous osteotomy but applied a fixator. He reported of 71 cases in 44 children.…”

Section: Clinical and Radiological Results Of Torsional Osteotomiesmentioning

confidence: 99%

“…Erschbamer et al 35 also published a method of percutaneous osteotomy but in these cases an external fixator was applied after rotation. Pins are placed before osteotomy to control alignment and rotation.…”

Section: Distal Tibial Osteotomymentioning

confidence: 99%

Torsional Osteotomy

et al. 2019

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This article provides an overview of symptomatic torsional deformities of the lower extremity, and operative treatment techniques are described in detail. A definition of torsion versus rotation as well as information to physical examination and the relevance of radiological evaluation is given. Based on current literature and the own personal experience of the authors in osteotomies, surgical techniques at the proximal and at the distal femur, as well as at the tibia are presented.

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“…The current methods of treating tibial fractures mainly include the surgical ones and nonsurgical ones [ 3 , 4 ]. Nonsurgical methods include small splint external fixation and plaster external fixation; surgical methods mainly include internal fixations with interlocking intramedullary nails, general compression steel plates, external fixators, and locking compression plates combined with minimally invasive percutaneous plate osteosynthesis [ 5 , 6 ]. If the treatment measures are unreasonable, it will cause many complications with the higher possibility of the disunion of fracture and skin necrosis [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Effect Evaluation of Perioperative Fast‐Track Surgery Nursing for Tibial Fracture Patients with Computerized Tomography Images under Intelligent Algorithm

Zhang

Rao

2022

Contrast Media & Molecular Imaging

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This study aimed to study the application value of computerized tomography (CT) images under the graph cut algorithm in the effect evaluation of perioperative fast-track surgery (FTS) nursing in tibial fracture. In this study, 80 tibial fracture patients in the perioperative period were selected as the research objects. These objects were randomly divided into two groups according to the examination method. In group A, routine CT examination was performed; in group B, CT examination under the graph cut algorithm was applied. The imaging results showed that there were still 16 cases with collapse of group A and 34 cases with collapse of group B; the difference was statistically significant ( P < 0.05 ). As for 16 cases with collapse in both groups, the average collapse shown in group A was about 2.79 ± 1.31 mm, while that in group B was 5.51 ± 1.88 mm, with a statistically significant difference ( P < 0.05 ). The average broadening in the images of group A was 3.17 ± 1.41 mm and that of group B was 5.72 ± 1.83 mm, suggesting that the difference was statistically significant ( P < 0.05 ). The broadening distance of 3-4 mm was mainly shown in the images of group A and that of 5-8 mm was shown in group B, with a statistical difference ( P < 0.05 ). In terms of the total score, there were 26, 44, 8, and 2 cases that were assessed as excellent, good, common, and bad, respectively, in group A, while 44 cases were assessed as good and 36 cases were assessed as common in group B, which were significantly different ( P < 0.05 ). In summary, the graph cut algorithm not only had a good segmentation effect and segmentation efficiency but also could improve the evaluation of CT images for perioperative FTS nursing effect in patients with tibial fracture.

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Distal tibial derotational osteotomy with external fixation to treat torsional deformities: a review of 71 cases

Cited by 16 publications

References 23 publications

Idiopathic Rotational Abnormalities of the Lower Extremities in Children and Adults

Idiopathic Rotational Abnormalities of the Lower Extremities in Children and Adults

Torsional Osteotomy

Effect Evaluation of Perioperative Fast‐Track Surgery Nursing for Tibial Fracture Patients with Computerized Tomography Images under Intelligent Algorithm

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