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Re: Деформация голеней
T. Derek V. Cooke 14 Сентябрь 2005, 18:23
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Hi Alex:
Nice job!
It is very interesting to me that as you have derotated the tibia you have centred the patella, I think and the prox tibia looks much more anatomic.
The analysis in the attached images is direct, just using the tools.
Tibial tilt is perhaps more than you want but the tibial correction is to 90 (very slight over
correction.
Will need full length views to tell us about the hka but it appears neutral.
Measurements took 4 mins
Derek
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Re: Деформация голеней
Alexander Chelnokov 15 Сентябрь 2005, 19:46
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TDVC> Nice job!
Thx.
TDVC> It is very interesting to me that as you have derotated
TDVC> the tibia you have centred the patella, I think and the prox
TDVC> tibia looks much more anatomic.
But it results with approproiate external rotation of the hip. What problems does it solve and generate?
TDVC> Tibial tilt is perhaps more than you want
Tibial tilt remains unchanged. According to Paley's "Principles of deformity correction" normal range of proximal posterior tibial angle is 80+/-3.5 degrees.
TDVC> but the tibial correction is to 90 (very slight over
TDVC> correction.
Or just in upper part of normal range?
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Re: Деформация голеней
Отправитель: T. Derek V. Cooke 15 Сентябрь 2005, 19:49
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Hello Alex:
The 'insquint', Patella 'looking in' with feet ahead, is a due to tibail Ext malrotation.
Cooke, T.D.V., Price, N., Fischer, B., Hedden, D. (1990): The inwardly pointing knee. An unrecognized problem of external rotational mal-alignment. Clin. Orthop., 260:56-60.
Whether by intention or design I think you derotated this with your osteotomy.
Did you show us the preop tibial alignment? Our data for posterior tibial tilt is a mean of closer
to 10 degrees (Yoshioka, Y., Siu, D., Scudamore, R.A., Cooke, T.D.V. (1989) Tibial anatomy and functional axes. J. Orthop. Res., 7:132-137.)
Regards
Derek
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