EVALUATION

Torsional lesions cause leg pains, and have a great impact on a person’s gait. For example, a high femoral antetorsion can lead to knee pain whilst jogging. Torsion of quadriceps is often very high in the case of dislocation of the kneecap, as it pulls the patella on the lateral side.

Specific treatments can be performed using intramedullary nails.

Here are the signs of torsional deformity:

• Acetabulum torsion: the hip cup in the pelvis is watching forward by 8-12°
• Femoral torsion: when the knee is forward, the hip is tilted anteriorly by 12° (range 6-20°)
• Tibial external torsion is 20-40°
• The quadriceps are externally rotated by 10-30° in relation to the knee.
• Torsion changes during growth.

The 16 year-old patient had a genu varum, knee recurvatum and quadruple torsion syndrome. Correction of all deformities was handled with stab incisions and intramedullary nails through only 2 surgeries. The patient could then walked fast (3 weeks after each surgery) with feet aligned, and could run later with no pain.

The 16 year-old patient had a genu varum, knee recurvatum and quadruple torsion syndrome. Correction of all deformities was handled with stab incisions and intramedullary nails through only 2 surgeries. The patient could then walked fast (3 weeks after each surgery) with feet aligned, and could run later with no pain.

 

TORSIONAL DEFORMITIES OF BONES

This can be corrected using stab incisions.

The femurs can be sometimes involved, as well as the tibias, but sometimes surgery must be performed on both the femur and the tibia, such as in the case of quadruple torsion syndrome. When patients experience trouble jogging, corrections can be made to both the femora and tibiae.

 

TORSIONAL DEFORMITIES OF MUSCLES

The quadriceps are placed too laterally with respect to the kneecap and patellar groove on the femur (hyper-quadriceps torsion), which can pull the patella (kneecap) laterally, resulting in hyper-pressure of the patella (pain even in adulthood) or dislocation of the kneecap.

Dislocation of the patella due to a too lateral position of the quadriceps and retroversion of femoral neck. A double osteotomy of the femur was performed to realign the quadriceps over the knee femoral groove.

Dislocation of the patella due to a too lateral position of the quadriceps and retroversion of femoral neck. A double osteotomy of the femur was performed to realign the quadriceps over the knee femoral groove.

Patient having pain at jogging, climbing stairs, etc. A torsional analysis showed abnormal quadriceps torsion with retroversion of femoral neck, requiring surgery, differently for both femurs.

Patient having pain at jogging, climbing stairs, etc. A torsional analysis showed abnormal quadriceps torsion with retroversion of femoral neck, requiring surgery, differently for both femurs.