Role of External Fixator Assistance in Tibial Rotation Osteotomy—Technique and Results

Abstract

Background: Idiopathic torsional deformities in children tend to resolve without intervention; however, pathologic torsion, which is primarily associated with neuromuscular diseases, requires surgical correction. We present a technique to assess the magnitude of tibial rotational osteotomy intraoperatively based on clinically simulating the degree of correction. Methods: A surgical technique is described, and a review of 8 rotational deformities of the tibia in 7 patients is presented. The data being collected included age, sex, date of surgery, diagnosis, and the magnitude of rotational deformity preoperatively and postoperatively. Results: There were 7 patients, of which 3 were females. The mean age was 10.5 years (5.5–18 y). The mean preoperative medial tibial rotation deformity in 7 segments was 20° (10–30°), and a lateral rotation of 40° was present in another segment. All deformities except one were corrected to an average of 10° external rotation. Conclusions: Our method differs from that of the common method used by most surgeons, in which pins are inserted before the tibial osteotomy at a predetermined angle, which represents the amount of desired final correction. We believe that the technique we present is easier on the surgeon, and the clinical results meet the planned presurgical expectations.