Combined Use of Taylor Spatial Frame and Wake-up Test for Acute Correction of Idiopathic External Torsion of the Tibia: A Case Report.

Abstract

Introduction:We herein report a case of idiopathic unilateral external torsion of the tibia treated with Taylor spatial frame (TSF) fixation combined with performance of the wake-up test under anesthesia. The wake-up test is performed toward the end of a surgical procedure after all corrections have been made and hardware has been placed. The patient is slowly awakened and asked to move their feet. After recovery from anesthesia, patients do not remember performing this test.Case Report:A 17-year-old Japanese male patient complained of a gait disturbance because of external torsion of his foot. The patient was determined to have lateral tibial torsion with a pre-operative foot progression angle of 40.8°. Deformity correction using the TSF was considered to be safe. The tibia was derotated by −34.8°, and the patient had a post-operative foot progression angle of 7.0°. His symptoms and signs improved after derotation osteotomy at the low tibial portion. Two years postoperatively, the patient exhibited no leg length discrepancy or rotation malalignment of the lower extremities as measured both clinically and radiographically.Conclusion:To the best of our knowledge, there are no reports on the combined use of the TSF and wake-up test for acute correction of idiopathic external torsion of the tibia. Intraoperative use of the wake-up test with subsequent TSF fixation is effective and safe for acute correction of limb deformities.