Torsional osteotomies of the femur

Dickschas, Jörg; Harrer, Jörg; Reuter, Benoit; Schwitulla, Judith; Strecker, W.

doi:10.1002/jor.22758

Cited by 77 publications

(70 citation statements)

References 35 publications

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“…This, however, could be important information when planning a derotational osteotomy. Currently, debate still surrounds the ideal site for an osteotomy, which can be performed proximally or distally [4,8,9,21,22]. If an osteotomy is performed at the site of the deformity, normal anatomy can be restored [6].…”

Section: Discussionmentioning

confidence: 99%

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Ferlic

Runer

Seeber

et al. 2017

International Orthopaedics (SICOT)

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Purpose De-rotational osteotomies are indicated in patients with pathologic femoral torsion. However, there is disagreement whether an osteotomy should be performed proximally or distally. Conventionally only the total torsion is measured, which does not allow differentiation between a torsional deformity located in the proximal or distal metaphysis or the diaphysis. The aim of this study is to validate a new multilevel measurement protocol for evaluation of the magnitude of torsion of the respective femoral segments in CT. Patients and methods The torsional profile of 30 femora was evaluated in CT scans. For separate measurements of the torsion of the metaphysis and the diaphysis, four axes where determined: one through the femoral neck, a second determined by the midpoint of the femoral shaft and the lesser trochanter, a third determined by a tangent dorsal to the popliteal surface, and a fourth axis posterior to the condyles. The total femoral torsion was measured between the first and the fourth axis, proximal torsion between the first and the second, mid torsion between the second and the third, and distal torsion between the third and the fourth axis. Four investigators performed all measurements independently and intraclass correlation coefficients (ICC) were calculated to evaluate intra-and inter-rater reliability. Results Average total femoral torsion was 22.6 ± 8.7°, proximal torsion 47.7 ± 10.6°, mid torsion −33.4 ± 9.9°, and distal torsion 8.3 ± 3.2°. Intra-rater ICC ranged between 0.504 and 0.957 and inter-rater ICC between 0.643 and 0.992. The majority of the ICC were graded as Balmost perfect^and some as Bsubstantial^agreement. Conclusion Evaluation of the segmental torsion of the femur allows in-depth analysis of femoral alignment. High reliability was shown for this measuring method in computed tomography, which can be deployed when studying interdependencies between joint pathologies and torsional deformities or when planning the site for an osteotomy. Level of evidence Level III.

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Section: Discussionmentioning

confidence: 99%

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Ferlic

Runer

Seeber

et al. 2017

International Orthopaedics (SICOT)

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“…The median DFT, PTT, TT-TG distance, and AT was À8 (À6 to À8) degrees, 9 (5 to 12) degrees, 14 (11)(12)(13)(14)(15)(16)(17) mm, and 14 (9-21) degrees, respectively (►Table 1). The linear regression shows a significant correlation between TT-TG and AT (p ¼ 0.01), with an R 2 of 0.10 (►Table 2).…”

Section: Resultsmentioning

confidence: 99%

The Distance between Tibial Tubercle and Trochlear Groove Correlates with Knee Articular Torsion

et al. 2020

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This study aims to correlate the tibial tubercle to trochlear groove (TT-TG) distance with knee axial alignment. The hypothesis is that as internal torsion of the distal femur or external torsion of the proximal tibial increases, the TT-TG distance increases. We designed a cross-sectional study approved by our institutional ethics review board. We reviewed 32 computed tomography angiographies of patients that have nonjoint or bone-related symptoms. Distal femoral torsion, proximal tibial torsion, knee articular torsion (AT), and TT-TG distance were measured. A regression analysis between the TT-TG distance and the AT was performed. A positive correlation between the TT-TG distance and the AT was found. An increase in external torsion of the proximal tibial or an increase in internal torsion of the distal femur increases the TT-TG distance. For a correct interpretation of the TT to trochlear groove distance, we propose that the axial alignment should be included in the regular analysis of patellofemoral disease.

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“…Excellent results were also shown at tibial torsional osteotomies. 28 Strecker and Dickschas 27 reported 53 tibial internal torsional osteotomies in 45 patients. Mean external tibial torsion was 47.4 degrees, the average correction angle was 10.8 degrees.…”

Section: Clinical and Radiological Results Of Torsional Osteotomiesmentioning

confidence: 99%

“…However, if there is a deformity in two planes an oblique osteotomy can be considered for correction. 26 The distal femur osteotomy to correct the torsion is widespread 27,28 and since the minimal invasive techniques are available, they are becoming even more popular.…”

Section: Femur 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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Torsional osteotomies of the femur

Cited by 77 publications

References 35 publications

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

Segmental torsion assessment is a reliable method for in-depth analysis of femoral alignment in Computer Tomography

The Distance between Tibial Tubercle and Trochlear Groove Correlates with Knee Articular Torsion

Torsional Osteotomy

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