Tibial torsion errors

Tibial torsion defects are usually not clinically evident and, hence, are o ften overlooked. Clinical examination and CT scan have proved to be the bes t ways of measuring static tibial torsion,whereas dynamic measurements are usually performed in the clinic and the "gait laboratory." Only few studies have determined there to be a connection between a torsion defect in the l ower leg and expected pathological conditions of the knee and ankle joints. However, patellofemoral instability, Osgood-Schlatter disease, osteochondr osis dissecans are increasingly being found in cases of increased external tibial torsion and arthrosis in reduced torsion. Although spontaneous correction may occur in certain cases, in others the o nly way to correct the condition is by employing physiologic torsion. Conse rvative treatment methods such as bandages or ortheses have been shown to n ot have any effect on torsion; thus,surgical treatment is the only successf ul way to correct a pathologic angle of rotation of the tibia. For this, su pramalleolar osteotomy with fixation using Kirscher wires and plaster or an external fixator are the most common treatments.