Evaluation of Incidence of Tibial Mal Rotation after Closed Tibial Intra-Medullary Nailing and its Effects on Clinical Outcomes of the Patients: A Prospective Study

Abstract

Background: Incidence of tibial malrotation (more than 10 degrees of tibial rotation in comparison with contralateral tibia) following intramedullary fixation originally ranged from 0 to 6 and different complications were reported including: Cosmetic appearance concerns, impaired gait specially crouch gait when more than 30 degrees of malrotation happens, foot adopting a pes planus position. Materials and Methods: This prospective study was performed from January 2022 to June 2024. A total of 245 patients with tibial mid-diaphyseal fractures underwent closed intra medullary nailing and basic data including age of the patients, their genders, BMI and surgery durations and post-operative outcome variables including lower extremity functional scale (LEFS), six minute walk test (6 MWT) and SF 36 questionnaire were collected. Results: From 245 of the patients 237 of them were included in the study and basic data including age of the patients, their genders, BMI and surgery durations were not significantly different between two groups (P value > 0.05). Post-operative outcome variables including LEFS, 6 MWT and SF 36 questionnaire was measured and no significant difference between two groups is reported (P value > 0.05). Conclusion: Age, gender, BMI, and surgical time had no meaningful relationship with incidence of tibial malrotation after closed tibial intra medullary nailing. Clinical outcomes are not significantly different between two groups, which it means that tibial torsion will not affect clinical outcomes of the patients.