Purpose: To review the outcomes of tibial derotational osteotomies (TDOs) as a function of complication and revision surgery rates comparing a cohort of children with myelodysplasia to a cohort with cerebral palsy (CP).
Methods: A chart review was completed on TDOs performed in a tertiary referral centre on patients with myelodysplasia or CP between 1985 and 2013 in patients aged > 5 years with > 2 years follow-up. Charts were reviewed for demographics, direction/degree of derotation, complications and need for re-derotation. Two-sample T-tests were used to compare the characteristics of the two groups. Two-tailed chi-square tests were used to compare complications. Generalised linear logit models were used to identify independent risk factors for complication and re-rotation.
Results: The 153 patients (217 limbs) were included. Average follow-up was 7.83 years. Overall complication incidence was 10.14%, including removal of hardware for any reason, with a 4.61% major complication incidence (fracture, deep infection, hardware failure). After adjusting for gender and age, the risk of complication was not statistically significantly different between groups (p = 0.42) nor was requiring re-derotation (p = 0.09). The probability of requiring re-derotation was 31.9% less likely per year increase in age at index surgery (p = 0.005).
Conclusion: With meticulous operative technique, TDO in children with neuromuscular disorders is a safe and effective treatment for tibial torsion, with an acceptable overall and major complication rate. The risk of re-operation decreases significantly in both groups with increasing age. The association between age at initial surgery and need for re-derotation should help guide the treatment of children with tibial torsion.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584491 | PMC |
| http://dx.doi.org/10.1302/1863-2548.11.170037 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Purpose: Tibial rotational deformity is a known risk factor for patellofemoral joint (PFJ) disorders. However, it is commonly associated with other abnormalities which affect the PFJ. The purpose of this study was to describe the prevalence of associated factors known to affect PFJ in patients undergoing rotational tibial osteotomy and their implication for the correction level.
View Article and Find Full Text PDFComparable postoperative outcomes in patients treated with either open or arthroscopic trochleoplasty for patella dysplasia.
Knee Surg Relat Res
December 2024
Department of Orthopaedics Surgery, AUVA Trauma Center Klagenfurt, Waidmannsdorferstraße 35, 9020, Klagenfurt Am Wörthersee, Austria.
Background: The aim of this study was to compare the clinical and radiologic results of the arthroscopic and the open trochleoplasty techniques.
Methods: A total of 83 trochleoplasties in 83 patients were performed between 2014 and 2021 in one institution. Surgical indications for trochleoplasty were recurrent patellofemoral instability and a lateral trochlear inclination angle (LTI) ≤ 11˚ and a trochlear depth ≤ 6 mm.
Treatment of rotational tibial malunion after minimal invasive plate osteosynthesis (MIPO): Corrective osteotomy with original plate retention (PR-Osteotomy).
Injury
September 2024
Hip Department (CAD) Gaetano Pini-CTO Orthopedic Institute, University of Milan, P.za Cardinal Ferrari 1, 20122, Milano, Italy.
Background And Purpose: Residual axial and rotational deformities in tibial shaft fracture, after minimally invasive osteosynthesis (MIO) treatment, are widely described in literature. Nevertheless, there is still a lack of evidence about the malunion treatment strategies and results. The aim of our study is to present an innovative technique for tibial shaft malunion: a derotational proximal tibial osteotomy without removing the original plate (Plate-Retaining-Osteotomy: PR-Osteotomy).
View Article and Find Full Text PDFSevere vascular complications after derotational osteotomy of the tibia salvaged with free functional latissimus dorsi muscle transfer. A case report.
JPRAS Open
December 2024
Radboud Peripheral Nerve Centre, Department of Plastic and Reconstructive Surgery, Radboud university medical center, Nijmegen, the Netherlands.
We present a case study of a 26-year-old male who sustained severe vascular and neurogenic injury during derotational osteotomy of the tibia. Directly postoperatively he complained of a drop foot, but 3 days later presented with an ischemic compartment syndrome of the anterior and lateral compartments. After debridement the osteotomy and metalware were exposed and the patient had a drop foot.
View Article and Find Full Text PDFManagement of rotational malalignment following operative treatment of fractures of the lower extremities. A scoping review.
Injury
November 2024
Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium. Electronic address:
Article Synopsis
- Rotational malalignment after lower extremity fracture treatment can lead to increased pain and functional issues, but there are no standard guidelines for how to manage it.
- A scoping review was conducted to gather and synthesize existing evidence on diagnosing and treating these rotational deformities, analyzing 50 relevant studies out of an initial pool of 3929 records.
- Most studies focused on the femur and tibia, primarily used CT scans for diagnosis, and commonly employed internal fixation for treatment, showing that revision surgeries generally yielded positive outcomes with low complication rates.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!