Minimally invasive plate osteosynthesis for tibial derotation osteotomies in children with cerebral palsy

Abstract

Objective: Tibial derotation osteotomy can be used in the treatment of rotational deformities in case of ineffective conservative management. Our aim was to evaluate the results of the patients who underwent minimal invasive plate osteosynthesis for tibial derotation osteotomies. Methods: Total of 16 patients (17 procedures) were included in this study. Mean age was 11.5 (3–25) years. We clinically assessed the tibial torsion by measuring the thigh-foot angle (TFA). No immobilization was used postoperatively and range of motion exercises were begun immediately. The patient was allowed weight-bearing activity, as tolerated, when callus formation was seen on the radiographs, at approximately three to four weeks after surgery. Results: The mean follow-up time was 27.5 months. Mean preoperative and follow up TFA were 27° of internal rotation and 3.74° of external rotation, respectively. A mean of 22.3° improvement was achieved postoperatively. There was only one wound detachment, which was accepted as a complication and healed with local wound care. Conclusions: The recurrence risk and correction loss can be decreased with plate-screw fixation. Minimal invasive surgery would also decrease the risk of wound complications. Level of evidence: Level IV, Therapeutic study. Keywords: Tibial osteotomy, Cerebral palsy, Derotation, Intoeing, Minimal invasive