Torsional Malalignment Research Articles

Treatment of Severe Torsional Malalignment Syndrome

Treatment of Severe Torsional Malalignment Syndrome

Rotational osteotomy of the distal tibia and fibula.

A surgical technique for distal transverse osteotomy of the tibia and fibula to correct torsional malalignment of the leg is described. Thirty-two derotation osteotomies have been performed on 19 patients, whose average age at the time of surgery was 12 years; average follow-up was 2 years. Average torsional change following surgery was 38 degrees. Ninety-four percent of the patients available for follow-up (16 or 17) had a successful outcome. The two small incisions required in this procedure are cosmetically acceptable, and the location of the osteotomy in metaphyseal bone provides stability. We conclude that this osteotomy is a simple, safe, and effective procedure for correction of torsional malalignment in carefully selected patients.

The quadriceps angle and its relation to femoral torsion.

In 29 patients with patellofemoral complaints paired values of Q-angle and internal hip rotation were determined. In addition the patellar height index of Insall & Salvati (1971) was calculated from measurements on lateral radiographs of the knees. Both Q-angle and internal hip rotation were significantly higher in women than in men and there was a statistically significant correlation between these two measurements. There was no significant correlation between Q-angles and patellar height indexes. As external hip rotation can generally be taken as a measure of internal femoral torsion, these findings favour the hypothesis of a torsional malalignment syndrome of the patellofemoral joint.