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The effect of tibial rotational deformity on ankle joint loadings: A finite element analysis
Alp Er Tunga Bolukbasi1, Onur Kocadal2, Burak Cagri Aksu2
1Department of orthopaedics and traumatology, Acibadem Atasehir Hospital, Istanbul, Turkiye.
Background:
Tibial shaft fractures are common, and malrotation is a frequent complication after intramedullary nailing. This study evaluated the effect of tibial malrotation on ankle joint loading using finite element analysis.
Methods:
Finite element models were created from Visible Human Project CT data. A distal one-third transverse tibial shaft fracture was fixed with an intramedullary nail. Seven models were analyzed: neutral, 5°, 15°, and 25° internal rotation (IR), and 5°, 15°, and 25° external rotation (ER). A 2500 N axial load was applied, and tibiotalar cartilage and implant stresses were assessed.
Results:
Tibiotalar cartilage loading increased with malrotation, peaking in the 25° IR model. Internal rotation consistently produced greater stresses than equivalent external rotation.
Conclusion:
Tibial malrotation increases ankle cartilage loading after intramedullary nailing. Internal rotation causes greater biomechanical changes than external rotation and may increase the risk of ankle arthrosis.
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