Objective: To study deformities in tibial fractures that are treated orthopedically.
Material and Methods: A prospective study of 42 tibial fractures treated orthopedically (1996–2003), Average age was 8.9 years, Nineteen (45.2%) were male and 23 (54.3%) were female. Average follow-up was 59.6 months. Nineteen of the fractures (45.2%) were medial third and 23 (54.8%) were distal. The fracture line was spiral in 26 cases (61.9%), oblique in 10 cases (23.8%) and transverse in 6 (4.8%). In 18 cases (42.9%), there was a facture of the fibula and in 24 cases there was not (57.1%). Exclusion criteria: previous fractures, angular deformities less than 5 and surgical treatment. At one year post-concolidation, antero-posterior and lateral X-rays were taken and if the angular deformity was greater than 5 a tibial CT was done to measure axial rotation. Descriptive statistical and non-parametrical studies was done with signification p <
0.05.
Results: Varus deformity was 5.8, valgus 6, recurvatum 6.5 and antecurvatum 4, In 23 cases (54.8%), an association varus and recurvatum was found, in 9 cases (21.4%) valgus- recurvatum were associated, and in five cases each there was varus- and valgus- antecurvatum associations (11.9%). Healthy tibia had an external rotation of 38.2, while the rotation of fractured tibia was virtually the same at 38.5. In fractures of the medial third, external rotation decreased 8.3(55.6% cases). When the fibula was intact, external rotation was 6.4(40%) and decreased 8.7 (17.5%). When was fractured, decreased 6.5(30% cases). Localization and fracture line had no impact on results. external tibial rotation was greater for intact fibula than for fractured ones (p= 0.03).
Conclusions: 1) The majority of tibias treated orthopedically consolidated in varus or valgus-antecurvatum, 2) When there was a lesion of the fibula, the consolidation of the external rotation of the tibia increased, when there was no lesion to the fibula, it decreased.