Fluoroscopy of rotation in tibial fractures

Tibial torsion was assessed fluoroscopically in 38 patients with unilateral tibial fractures. Measurements were performed bilaterally after fracture reduction and stabilization. The difference in torsion between the respective tibias of each subject was calculated, and the result was compared with the values obtained from measurements in 100 normal adults with the same fluoroscopic method. A tibial torsion difference exceeding the normal mean +/- SD was found in 26 patients. The maximum difference was 49 degrees, as compared with 15 degrees in normal adults. In order to reduce the risk of disabling malrotation, measurement of tibial torsion in the operating room is recommended.