Improved function and joint kinematics after correction of tibial malalignment

Malunion after tibia fracture can have a negative effect on a patient's gait, joint kinematics, and functional outcome. We conducted a study to determine whether surgical correction of malunited tibias improves gait, joint kinematics, and patients' perception of their health and overall well-being. Eleven patients with tibial malunions were treated with osteotomy, deformity correction, and open reduction and internal fixation (ORIF). Minimum follow-up was 7 months (mean, 11 months; range, 7-17 months). In all cases, the osteotomy eventually healed. Two patients needed revision surgery: One had late collapse of the regenerate bone and underwent revision ORIF away from the site of deformity correction; the other required exchange intramedullary nailing. Surgical correction of malunited tibia fractures resulted in significant improvement toward the normative in lower extremity joint kinematic values and patients' perceptions of their health and overall well-being. Surprisingly, there was little effect on gait. Symptomatic malunited tibia fractures should undergo surgical correction, as it is likely to improve overall lower extremity function and patient satisfaction.