Rotational deformities of tibia diaphises after surgical treatment

ABSTRACT In this study, it was aimed to reveal postoperative tibial rotation values and to what extend these values are affected from such factors as patient age, fracture type and localization on the patients undergoing treatment due to tibia fracture by scanning computerized tomography which shows the presence and amount of tibial rotation clearly. 163 patients who were operated between January 2010 - October 2017 due to tibia fracture in Ege University Medical Faculty Hospital Ortopedive Traumatology Department were retrospectively determined. Of these patients, 115 patients without pre-op or post-op tibial computerized tomography were excluded from the study. Twenty patients with preoperative angio CT taken during admission to emergency department were identified. 20 unilateral tibia fractures 13 of which were right and 7 were left tibia fracture were detected. Angiocardial CT revealed that the intact tibias of 16 of the patients were also included in the imaging and that these were suitable for tibia rotation measurement. Of these 16 non-fractured tibia, 5 were right, 11 were left tibia and were included in the study to calculate the mean physiological tibia rotation. It was also detected that postoperative computed tomography involving tibia had been performed in 30 patients and that these were suitable for tibial torsion measurement. It was found that 14 of these tibias were left and 16 were right. Twenty-five of CTs performed on patients showed that the intact tibias were also included in the imaging and could be measured for tibia rotation measurement. It was observed that 14 of these intact tibias were right and 11 left tibia. Within the scope of the study, rotation measurements were made on a total of 89 tibias, 39 intact, 20 pre-op and 30 post-op. Although there was no observed correlation between post-op rotation value and fracture type, it was thought that lower rotation was easier to reach in segmental fractures. Statistically significant results were obtained between the fracture site and the post-op varusvalgus alignment. Probability of operation is falling from proximal 1/3 to distal 1/3. Pre-op anglulations appear to be related to post-op anglulations. The smaller pre-op anglulation, the less likely is the surgical operation chance to emerge, which is parallel to the post-op anglulation. It was observed that measuremental differences of up to 5 degrees between the two sides seen in the measurements performed on intact tibias could be due to physiological reasons. The rotational difference ratio exceeding 10 degrees was found to be 43% in the results of 23 patients whose intact and post-op fractures could be measured in terms of measuremental and angular differences.