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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2020, Number 5

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Acta Ortop Mex 2020; 34 (5)

Surgical management of gait by internal tibial torsion in children

Oliveros-Rivero JA, Mendoza-Saldarreaga LG, Forestieri-Flores M, Quiñonez-León J, Melgar-Celleri J
Full text How to cite this article 10.35366/97986

DOI

DOI: 10.35366/97986
URL: https://dx.doi.org/10.35366/97986

Language: Spanish
References: 10
Page: 267-271
PDF size: 296.39 Kb.


Key words:

Gait, treatment, tibial torsion, osteotomy, evolution.

ABSTRACT

Introduction: Identify the progress of patients who had internal tibial torsion and were treated with surgical correction, performing derotating tibial osteotomy. Material and methods: Retrospective study included patients diagnosed with abnormal gait-causing internal tibial torsion in which conservative treatment failed, between January/2016 and January/2019. Results: 12 patients with an age range of 4.3-17.8 years of whom nine patients (75%) were female and three (25%) male; the weight range was 12.36-59.30 kg; among the associated pathologies were found myelomeningocele three patients (25%), cerebral palsy two patients (16.6%); the postoperative hospital stay of six patients (50%) one day, five patients (41.67%) stayed two days, and three days only one patient (8.33%); three patients (25%) minor complications and one patient (8.33%) major complications; progress was good in 11 patients (91.67%) and regular in one patient (8.33%). Conclusion: It is the first series communicated in Ecuador, where reference is made to the use of tibial osteotomy in the supramaleolar area, combined with Kirschner pin fixation, correcting internal tibial torsion in children where conservative treatment failed, resulting in a safe procedure and favorable results in the evolution of gait, including patients with neuromuscular disease and under five years of age.


REFERENCES

  1. Pons FA. Importancia de las torsiones tibiales en el desarrollo infantil de los 4 a 7 años. [Trabajo final de grado]. Barcelona: Universitat de Barcelona; 2015, 48.

  2. Accadbled F, Mansat C, Cahuzac J-P. Anomalies rotationnelles des membres inférieurs chez l’enfant. Paris: EMC (Elsevier Masson SAS, Paris); 2007.

  3. Davids JR, Davis BR, Jameson LC, David EW, James WH. Surgical management of persistent intoeing gait due to increased internal tibial torsion in children. J Pediatr Orthop. 2014; 34(4): 467-73.

  4. Staheli LT. Ortopedia pediátrica. Madrid: Marbán; 2003.

  5. Chauca JC. Deformidades torsionales de los miembros inferiores y la alteración del equilibrio dinámico en niños de 4 a 7 años. [Trabajo final de grado]. Lima: Universidad Nacional Mayor de San Marcos; 2008. 76.

  6. Losada BP. Alteraciones de los miembros inferiores: deformidades angulares, torsionales, alteraciones de la marcha y dismetrías. Pediatr Integral. 2002; 6(5): 397-412.

  7. Joseph B, Nayagan S, Loder R, Torode I. Paediatric orthopaedics. 2nd ed. Florida: CRC press; 2016.

  8. Krengel WF, Staheli LT. Tibial rotational osteotomy for idiopathic torsion: a comparison of the proximal and distal osteotomy levels. Clin Orthop Relat Res. 1992; 283: 285-9.

  9. Selber P, Filho ER, Dallalana R, Pirpiris M, Nattrass GR, Graham HK. Supramalleolar derotation osteotomy of the tibia, with T plate fixation. J Bone Joint Surg. 2004; 86(B): 1170-5.

  10. Dodgin DA, De Swart RJ, Stefko RM, Wenger DR, Ko J. Distal tibial/fibular derotation osteotomy for correction of tibial torsion: review of technique and results in 63 cases. J Pediatr Orthop. 1998; 95-101




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Acta Ortop Mex. 2020 Sep-Oct;34