Assessment of tibial torsion and rotational deformity with a new fluoroscopic technique

No conventional technique for routine assessment of tibial torsion and the twist of the distal versus the proximal articular axis of the tibia after reduction of a fracture has yet gained general acceptance. Considering the demands for availability, simplicity, applicability, and precision, a new method employing a mobile C-arm fluoroscope equipped with a protractor is used for assessment. After fracture reduction and stabilization by a mechanical method of fixation or by a conservative method with a plaster cast, the rotational situation of the tibia can be determined before the patient leaves the operating room. Measurements can be performed under sterile conditions. The method was applied clinically and in a study of tibial torsion in normal adults. The standard error of a single measurement was less than 1 degree. The maximum difference in tibial torsion between the legs of the same normal individual reached 15 degrees.