Long-term Outcome of Internal Tibial Derotation Osteotomies in XXXX With @entity306 .

@entity1 @entity717 @entity5109 @entity4957 @entity2270 @entity4803 @entity85 @entity10819 @entity306
BACKGROUND: External tibial torsion (ETT) is a common @entity85 in @entity1 with @entity306 ( @entity306 ). The current recommended treatment is @entity4957 ( @entity4957 ) to improve gait biomechanics. Satisfactory short-term results after @entity4957 have been reported but long-term results have not been studied. The purpose of this study was to evaluate the long-term outcome following @entity4957 to correct ETT in ambulatory @entity1 with @entity306 . METHODS: Following IRB approval, gait kinematics and passive range of motion measurements were retrospectively evaluated in @entity1 with @entity306 who underwent @entity4957 due to ETT comparing preoperative (E0), short-term postoperative (E1; 1 to 3 y post), and long-term postoperative (E2; >5 y post) results. Limbs were categorized as corrected, undercorrected, or overcorrected at both @entity4803 , by comparing mean tibial rotation (MTR) in gait to a group of typically developing @entity1 . Age at surgery, E0 MTR, E0 gait velocity, gross motor function classification system (GMFCS) score, and @entity5109 were evaluated to determine their influence on long-term results. RESULTS: The study sample consisted of 43 legs (with @entity10819 ) and 22 legs (with E0, E1, and E2). The mean age at surgery was 10.3  3.4 years (range, 6 to 19.2 y). In the group MTR trended toward improvement moving from -26  17 degrees (E0, external negative) to -16  16 degrees (E1) and relapsed to -23  17 degrees at the long term (P=0.071, E0/E1; P=0.589, E0/E2). Improvement was also seen in the @entity2270 (P=0.074), mean @entity717 , and mean foot orientation (P<0.05, E0/E2). At the long-term evaluation, 16 legs (37%) were found to be in the kinematic corrected group, 25 legs (58%) in the kinematic undercorrected group, and 2 legs (5%) in the kinematic overcorrected group. There were no significant differences between the corrected and undercorrected groups of @entity1 with respect to age at surgery, GMFCS, E0 MTR, gait velocity, or @entity5109 . CONCLUSIONS: Although internal @entity4957 improves ETT in the short term, recurrence is frequent with an apparent developmental trend toward external rotation of the tibia. LEVELS OF EVIDENCE: Level IV-therapeutic study.
