The Journal of Bone and Joint Surgery, Vol 77, Issue 2 240-246, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Oblique osteotomy for the correction of tibial malunion
R Sanders, JO Anglen and JB Mark
Orthopedic Trauma Service, Tampa General Hospital, Florida.
Fifteen patients had an oblique osteotomy of the tibia for the correction
of a multiplanar deformity between January 1989 and March 1991; twelve were
followed for an average of twenty-five months (range, twelve to forty-two
months). Preoperatively, the average deformity in the coronal plane was 14
degrees (range, 30 degrees of valgus to 25 degrees of varus) and the
average deformity in the sagittal plane was 13 degrees (range, 40 degrees
of recurvatum to 23 degrees of procurvatum [angulation convex anteriorly]).
The average leg-length discrepancy was 2.2 centimeters (range, one to six
centimeters). No patient had a rotational deformity. After careful
preoperative planning, all patients had an oblique osteotomy and placement
of a lag screw and a neutralization plate. Somatosensory evoked potentials
were monitored during any axial lengthening. A fibular osteotomy and
lengthening of the Achilles tendon were performed as needed. Full
weight-bearing on the extremity was prohibited until radiographic and
clinical examination indicated that union had occurred, which was at an
average of 4.5 months (range, three to six months). At the most recent
follow-up examination, ten patients had an excellent result. The average
correction in the coronal plane was to within 1 degree (range, 0 to 3
degrees) of normal and the average alignment in the sagittal plane was to
within 2 degrees (range, 0 to 12 degrees) of normal. An average of 1.3
centimeters (range, 0.5 to 2.5 centimeters) of lengthening was
obtained.(ABSTRACT TRUNCATED AT 250 WORDS)