A Novel Fluoroscopic Method for Assessing Rotational Malalignment of the Tibia

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael S. Roberts ◽  
Mark A. Haimes ◽  
Pamela Vacek ◽  
Michael Blankstein ◽  
Patrick C. Schottel
Keyword(s):  
Rotational Malalignment

Rotational Malalignment of the Tibia Following Reamed Intramedullary Nail Fixation

2004 ◽  
Vol 18 (7) ◽  
pp. 397-402 ◽  
Author(s):  
S. Puloski ◽  
C. Romano ◽  
R. Buckley ◽  
J. Powell
Keyword(s):  
Intramedullary Nail ◽  
Rotational Malalignment

scholarly journals Femoral malalignment after gamma nail insertion in the lateral decubitus position

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 34
Author(s):  
Hossam M.A. Abubeih ◽  
Osama Farouk ◽  
Mohammad Kamal Abdelnasser ◽  
Amr Atef Eisa ◽  
Galal Zaki Said ◽  
...  
Keyword(s):  
Case Series ◽  
Gamma Nail ◽  
Lateral Decubitus Position ◽  
Entry Point ◽  
Age Group ◽  
Rotational Malalignment ◽  
Implant Positioning ◽  
High Incidence ◽  
Nail Insertion ◽  
Lateral Decubitus

Introduction: Insertion of gamma nail with the patient in lateral decubitus position have the advantages of easier access to the entry point, easier fracture reduction and easier implant positioning. Our study described the incidence of femoral angular and rotational deformity following gamma nail insertion in lateral decubitus position. Methods: In a prospective clinical case series, 31 patients (26 males and 5 females; the average age of 42.6 years) with 31 proximal femoral shaft fractures that were treated with gamma IMN were included in our study. Postoperatively, computerized tomography scans of the pelvis and both knees (injured and uninjured sides) were examined to measure anteversion angles on both sides. A scout film of the pelvis and upper both femurs was taken to compare the neck shaft angles on both sides. Results: No angular malalignment was detected in our series; the mean angular malalignment angle was 1.6 ± 1.5°. There was a high incidence of true rotational malalignment of ≥10° in 16 out of 31 patients (51.6%); most of them were external rotational malalignment. Younger age group (≤40 years) had significantly more incidence of rotational malalignment (≥10°) than older age group (>40 years) (P-value 0.019). Discussion: Gamma nail fixation in lateral decubitus position without the fracture table gives an accurate and easier access to the entry point, good implant positioning with no or minimal angular malalignment (varus −valgus) but poses high incidence of true rotational malalignment. Great care and awareness of rotation should be exercised during fixing proximal femoral fractures in lateral decubitus position.

Compensation for rotational malalignment after intramedullary nailing for femoral shaft fractures

Injury ◽  
2004 ◽  
Vol 35 (12) ◽  
pp. 1270-1278 ◽  
Author(s):  
R.L. Jaarsma ◽  
B.F. Ongkiehong ◽  
C. Grüneberg ◽  
N. Verdonschot ◽  
J. Duysens ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Femoral Shaft ◽  
Rotational Malalignment ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Tibial and ankle fractures in children

2011 ◽  
Author(s):  
B.W. Scott ◽  
P.A. Templeton
Keyword(s):  
Soft Tissues ◽  
Skeletal Maturity ◽  
Distal Tibia ◽  
Femoral Fractures ◽  
Ankle Fractures ◽  
Minor Importance ◽  
Duration Of Treatment ◽  
Rotational Malalignment ◽  
Fractures In Children ◽  
Clinically Significant

♦ After forearm and digital injuries, tibial and ankle fractures are the commonest fractures in the immature skeleton and the majority of these involve the diaphysis or ankle♦ Compared to the morbidity seen in adults these are relatively forgiving injuries in children as the healing rate of bone and soft tissues is rapid and remodelling will occur♦ It is wise, however, to guard against overconfidence in the remodelling potential of certain injuries; for example, angulated mid-diaphyseal fractures, rotational malalignment, and metaphyseal fractures within 2 years of skeletal maturity♦ Children will tolerate manipulative/cast treatment better than adults as the duration of treatment is usually shorter and rapid rehabilitation is almost the norm with or without physiotherapy♦ Postfracture overgrowth does occur but is less than that following femoral fractures and seldom clinically significant (over 10mm)♦ Isolated fibular fractures are of minor importance but need to be taken into account in managing complex injuries involving the distal tibia♦ It is convenient to discuss injuries according to three anatomical sections: proximal, diaphyseal, and distal.

Automated Virtual Placement and Evaluation of Tibial Components for Knee Arthroplasty

2011 ◽  
Author(s):  
Yifei Dai ◽  
Mary S. S. Wentorf ◽  
Jeffrey E. Bischoff
Keyword(s):  
Knee Arthroplasty ◽  
Rotational Alignment ◽  
Implant Design ◽  
Rotational Axis ◽  
Rotational Malalignment ◽  
Tibial Tray ◽  
Key Factor ◽  
Total Knee ◽  
The Impact ◽  
Good Coverage

The ability of tibial tray component shapes to appropriately fit boney geometry is an important aspect of implant design in total knee arthroplasty. Overhang of components in the knee has been associated with soft tissue damage and joint pain [1,2]. Good coverage establishes stability through adequate cortical bone support of the tray component, and reduces the likelihood of loosening and subsidence [3–5], and therefore serves as a key factor in component fixation, especially in those that rely on biological growth into porous component backings such as Trabecular Metal™ Material. More importantly, rotational malalignment of the tibial tray can disrupt the natural kinematics and implant longevity [6]. Previous studies investigated coverage of multiple tibial trays on digitized bone resection contours [1,7]. However the methodology for rotational alignment during implantation was not identified. Although rotational alignment has been investigated in numerous studies, most of the studies were carried out by either investigating the impact of malalignment [6], or assessing different definitions of the tibia rotational axis [8]. No correlation between the size of the rotational alignment window and the amount of coverage has been shown.

Sa3.4 Rotational malalignment after femoral shaft fractures and its influence on daily life

Injury ◽  
2013 ◽  
Vol 44 ◽  
pp. S21
Author(s):  
Ö. Karaman ◽  
E. Ayhan ◽  
H. Kesmezacar ◽  
M.C. Ünlü ◽  
A. Seker ◽  
...  
Keyword(s):  
Daily Life ◽  
Femoral Shaft ◽  
Rotational Malalignment ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Rotational Malalignment After Intramedullary Nailing of Femoral Fractures

2004 ◽  
Vol 18 (7) ◽  
pp. 403-409 ◽  
Author(s):  
R. L. Jaarsma ◽  
D. F. M. Pakvis ◽  
N. Verdonschot ◽  
J. Biert ◽  
A. van Kampen
Keyword(s):  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Rotational Malalignment

Does the Surgical Correction of Tibial Torsion with Genu Varum Produce Outcomes Similar to Those in Varus Correction Alone?

2017 ◽  
Vol 31 (04) ◽  
pp. 359-369 ◽  
Author(s):  
Matthew Meade ◽  
Eugene Borst ◽  
Joseph Nguyen ◽  
S. Rozbruch ◽  
Austin Fragomen
Keyword(s):  
Close Association ◽  
Return To Sport ◽  
Patient Questionnaire ◽  
Entire Group ◽  
Tibial Osteotomy ◽  
Genu Varum ◽  
Tibial Torsion ◽  
Tibia Vara ◽  
Rotational Malalignment ◽  
Knee Pathology

AbstractThe aim of this article is to study the relationship between tibia vara and external tibial torsion in adults. The following questions were asked: (1) what is the incidence of rotational deformity in patients with genu varum and (2) do patients who undergo correction of tibial torsion with genu varum have similar outcomes to those who undergo simple tibia vara correction? In this study, 69 patients (138 limbs) underwent bilateral proximal tibial osteotomy for the correction of genu varum. Patients with simple coronal plane deformity (varus alone) were treated with either a monolateral external fixator or a hexapod frame. Those with concomitant external tibial torsion were treated with circular external fixation. The primary outcome was the ability to achieve the desired correction of alignment in the coronal, sagittal, and axial planes. Secondary outcomes included a postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) and a routine patient satisfaction questionnaire. The incidence of tibial torsion among the entire group of patients with bilateral tibia vara was 46% and overwhelmingly external in direction. The two groups had some significant differences in demographics with torsion patients tending to be younger and thinner. The final mechanical axis deviation and medial proximal tibial angle values for both groups did not differ significantly (p = 0.956). The postcorrection thigh–foot axis was not significantly different between the two groups (p = 0.666). Time to union was not significant (p > 0.999). KOOS was not different between the two groups in symptoms, pain, activities of daily living, and return to sport. There was a difference in the quality of life score between the two groups (p = 0.044). There was no difference between the two groups regarding the patient questionnaire. Based on the finding of this analysis, the incidence of rotational malalignment with genu varum is close to 50%. The recognition of this close association with external tibial torsion deformity may allow for further insights into the role of rotation in varus deformity-related knee pathology and treatment. Patients can expect nearly identical outcomes from this surgery.

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