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Related Experiment Video

Updated: May 5, 2026

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Peripheral Nerve Injury Following Tibial Osteotomy in Children. Is There a Role for Routine Prophylactic Common

Nisarg Mehta1, Stewart Morrison2, Chris Harris2

  • 1Department of Orthopaedics, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, Merseyside, UK.

Journal of Pediatric Orthopedics
|April 7, 2025
PubMed
Summary

Peripheral nerve injury occurred in 6.3% of pediatric tibial osteotomies, with 81% recovery. Risk factors included multiple osteotomies and acute valgus correction, suggesting selective prophylactic decompression.

Keywords:
common peroneal nervenerve decompressionperipheral nerve injurytibial osteotomy

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Neurology

Background:

  • Tibial osteotomy is crucial for limb lengthening and deformity correction in children.
  • Nerve injury is a potential complication, necessitating evaluation of risk factors and outcomes.

Purpose of the Study:

  • To assess long-term clinical outcomes of tibial osteotomy in children.
  • To identify risk factors for peripheral nerve injury, specifically common peroneal and tibial nerves.
  • To evaluate recovery rates and secondary outcomes like return to theatre.

Main Methods:

  • Retrospective analysis of 173 tibial osteotomies in 135 pediatric patients (excluding neuromuscular conditions) over 7 years.
  • Primary outcome: peripheral nerve injury; Secondary outcomes: return to theatre, deformity correction.
  • Statistical analysis to determine risk factors (e.g., multiple osteotomies, acute correction).

Main Results:

  • Overall nerve injury rate was 6.3% (3.5% in tibial lengthening cases).
  • 81% of injured patients achieved complete (45%) or partial (36%) recovery.
  • Significant risk factors for nerve injury: multiple osteotomies (RR: 1.30) and acute valgus correction (RR: 1.35).

Conclusions:

  • Nerve injury is a low-incidence complication of pediatric tibial osteotomy with a high recovery rate.
  • Prophylactic common peroneal nerve decompression may be considered for double-level osteotomies and acute valgus correction.
  • Informed consent regarding nerve injury risk is essential for shared decision-making.