Rotational osteotomies of the leg: tibia alone versus both tibia and fibula

From a chart review of 45 consecutive cases (mean age 8.9 years) of patients who had rotational osteotomies of the tibia alone (group 1, 27 cases) or of both the tibia and fibula (group 2, 18 cases) for torsional deformities of the leg, we compared the length of surgery and postoperative complications. We also describe the surgical technique for tibial osteotomy alone. The most common complication, posterior and varus/valgus angulation at the osteotomy site, was significantly higher in group 2 than in group 1 (p < 0.05). The mean operative time was 21% faster for tibial osteotomy alone. One case of chronic lateral compartment syndrome occurred in group 2. When indicated, tibial osteotomy alone is a simple, safe, fast, and stable surgical procedure for correcting excessive tibial torsion.