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Supramalleolar osteotomy: a comparison of fixation methods
Carolien P de Roode1, Man Hung, Peter M Stevens
1Department of Orthopaedic Surgery, Children's Mercy Hospital, Kansas City, MO 64108, USA. cderoode@cmh.edu
Journal of Pediatric Orthopedics
|July 2, 2013
Summary
Percutaneous pin fixation for tibial torsion showed fewer complications than plate fixation. However, outcomes were not comparable, with plate fixation requiring more secondary procedures for implant removal.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Skeletal deformities
Background:
- Persistent tibial torsion affects children, with various surgical techniques proposed.
- Comparison of percutaneous pin fixation versus plate and screw constructs is needed.
Purpose of the Study:
- To compare outcomes of percutaneous pin fixation versus plate and screw fixation for rotational supramalleolar osteotomy in children.
- To evaluate complication rates and need for secondary procedures.
Main Methods:
- Retrospective chart review of 125 patients (186 tibias) undergoing rotational supramalleolar osteotomy over 10 years.
- Data collected included age, torsion degree, procedure length, complications, and secondary procedures.
- Statistical analysis used the Mann-Whitney U test.
Main Results:
- No significant difference in surgical time, hospital stay, or recurrence between pin and plate fixation.
- Plate fixation group had significantly more secondary procedures (44 vs 3) and complications (12.8% vs 2.4%).
- Recurrence was associated with neuromuscular disease and younger age (<11 years).
Conclusions:
- Percutaneous pin fixation resulted in fewer complications and secondary procedures compared to plate fixation.
- The study did not support the hypothesis of comparable outcomes between the two fixation methods.
- Plate fixation is associated with a higher complication burden in pediatric tibial torsion surgery.
