Rotational osteotomy of the distal tibia and fibula

A surgical technique for distal transverse osteotomy of the tibia and fibula to correct torsional malalignment of the leg is described. Thirty-two derotation osteotomies have been performed on 19 patients, whose average age at the time of surgery was 12 years; average follow-up was 2 years. Average torsional change following surgery was 38 degrees. Ninety-four percent of the patients available for follow-up (16 or 17) had a successful outcome. The two small incisions required in this procedure are cosmetically acceptable, and the location of the osteotomy in metaphyseal bone provides stability. We conclude that this osteotomy is a simple, safe, and effective procedure for correction of torsional malalignment in carefully selected patients.