Accuracy of corrective osteotomies in fibular malunion: a cadaver model.

Abstract

While incorrect length of a fibular fracture reduction can be measured by plain radiographs, accurate imaging of rotational deformities requires computed tomography (CT). Operative correction of fibular malrotation has not been accurately measured. The aim of this study was to evaluate the accuracy of operative correction of fibular malrotation. Six pairs of formalin-fixed, lower leg cadaver specimens had shortening with additional internal or external rotation induced by segmental fibular resection and plate fixation. The deformity was measured by CT. Two experienced surgeons performed standardized corrective operations on six specimens each. The postoperative results were measured by CT. The mean overall accuracy for correction of malrotation was 1.58 degrees (SD = 0.8 degrees). There were no significant differences between the two surgeons performing the corrections. The accuracy of operative correction of malrotation in this cadaver model is in accordance with the requirements reported in clinical studies. Considering the error margin for CT analysis, correction within 5 to 10 degrees seems practical.