malalignment

Definition

Proximal metaphyseal tibial fracture 

Risk of delayed valgus deformity

Definition

Deformity causing alteration of mechanical axis from knee centre

Aims

1.  Normal leg alignment

2.  Equal leg lengths

Principle

Correct alignment and soft tissue balancing

- two of the most important aspects of successful TKR

Technical Goals

1.  Restoration of mechanical alignment

- forces of the leg pass through the centre of the hip, knee and ankle

Displaced Tibial Shaft Fractures

Acceptable reduction

- varus / valgus < 5^o

- anterior / posterior < 5^o

- rotation 5^o

- shortening 10 mm

Poor remodelling potential

- valgus 

- apex posterior angulation  / recurvatum

- rotational alignment does not remodel

- shortening / in 2-10 year old average overgrowth is only 5mm