Table 3.
Studies involving tibial shaft malunions.
| Study | Patients (#) | Surgical Treatment | Outcomes |
|---|---|---|---|
| Graehl et al. | 8 | Supramalleolar dome osteotomy or closed-wedge osteotomy | Improvement in pain in six patients; decrease in limping for 7 patients; improvement in sagittal plane deformity in all patients; coronal plane improvement in 1 of 3 patients with significant presurgical deformity |
| Sanders et al. | 12 | Oblique osteotomy | Correction of sagittal deformity to within 2° of normal; correction in coronal plane within 1° of normal; avg 1.3 cm of lengthening obtained; full range of motion (10); full-weight bearing; and return to previous employment (10); two patients failed initial revision |
| Kempf et al. | 7 | Reamed intramedullary nail | Good correction and all healed |
| Mayo and Benirschke | 23 | Reamed intramedullary nail | All healed, 1 infection with acceptable alignment |
| Sangeorzan et al. | 4 | Single-cut oblique osteotomy | All angular deformities were corrected. One patient developed deep infection, was successfully treated, and had a positive outcome |
| Wu CC et al. | 37 | Reamed intramedullary nailing | All patients’ deformities reached <10° angulation and/or rotation and <2 cm shortening; limping gait was corrected |
| Johnson | 7 | Multiplane corrective osteotomy | Lower-leg deformity and angulation improved in all patients; 2 patients had improved back pain; ipsilateral knee pain relieved (4); ipsilateral ankle discomfort resolved (2); improved back pain (2); gait improved in all patients; fibula nonunion (4) |
| LaFrance et al. | 1 | 2 stage: corrective fibula osteotomy followed by revision ACL reconstruction | Instability resolved |
| Feldman et al. | 11 | Taylor Spatial Frame | Mean alignment: coronal angulation 1.4°, sagittal plane 0.9°, shortening 4.4 mm, rotation 0.6° |
| Lahav and DiMaio | 1 | Opening-wedge osteotomy and total knee arthroplasty | Excellent range of motion and a stable knee to varus and valgus stress. Radiographs at two years illustrated a well-seated TKA and correction of tibial alignment |
| Paley et al. | 17 | Ilizarov | Angular > 5° rotation > 15° lld > 1.5 mean 4.5 cm |
| All corrected within 1.5 cm lld angular deformity < 5° and rotation < 10° |