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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 8, 1170-1175.
doi: 10.1302/0301-620X.86B8.14479  
Copyright © 2004 by British Editorial Society of Bone and Joint Surgery
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Supramalleolar derotation osteotomy of the tibia, with T plate fixation

TECHNIQUE AND RESULTS IN PATIENTS WITH NEUROMUSCULAR DISEASE

P. Selber, MD, FRACS, Orthopaedic Surgeon1; E. R. Filho, MD, Former Clinical Fellow2; R. Dallalana, MBBS, Research Fellow1; M. Pirpiris, MBBS, PhD, BMedSc, Grad Dip Epid, Biostat, FRACS, Research Fellow1; G. R. Nattrass, MD, FRCS (C), FRACS, Orthopaedic Surgeon1; and H. K. Graham, MD, FRCS (Ed), FRACS, Professor of Orthopaedic Surgery1

1 Orthopaedic Department, Royal Children’s Hospital, University of Melbourne, Department of Paediatrics and Murdoch Children’s Research Institute, Flemington Road, Parkville, Victoria 3052, Australia.
2 Association for the Assistance of Crippled Children, Av. Prof. Ascendino Reis, 724 São Paulo, SP 04027-000, Brazil.

Correspondence should be sent to Professor 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. A range of outcome variables was collected, prospectively, for 57 patients (91 osteotomies), including thigh foot angle, foot progression angle, post-operative complications and serial radiographs. Correction of thigh foot angle and foot progression angle was satisfactory in all patients. Three major complications were recorded; one aseptic nonunion, one fracture through the osteotomy site after removal of the plate and one distal tibial growth arrest.

We found that supramalleolar derotation osteotomy of the tibia, with AO-ASIF T plate fixation is an effective method for the correction of torsional deformities of the tibia and the associated disturbances of gait in children and adults with neuromuscular disease, with a 5.3% risk of major complications.




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Correction of rotational deformity of the tibia in cerebral palsy by percutaneous supramalleolar osteotomy
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[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General