Correctly applied and comfortable casts or braces designed by orthopaedic implant manufacturers can prevent the growth of angular deformities. If correctly used, such casts or braces can prevent deformities without causing excessive or unnecessary pressure on the soft tissues.
On the other hand, effective management of angular deformity is significantly negotiated in cases where the fibula is in an intact position. In fractures of the tibia with the connected fibula, angulation is disallowed by the compression of the muscle compartments, generally fluid-like chambers surrounding the fractured bone. The possibility of angular deformities of
Tibial fractures are a concern that needs to be addressed, as angulations can be unpleasant and potentially injurious to the neighbouring joints.
As the top titanium orthopaedic implant manufacturers in India, we have understood that angular deformities of 5° in any plane are typically complex to view with the naked eye and are, therefore, cosmetically acceptable. In many instances, deformities as high as 8° or 11° are also cosmetically acceptable by many. This conclusion is based on the years of observations of several thousand tibial fractures by our experts.
To our surprise, in some cases, we have even seen patients with angular deformities of up to 12° aesthetic deviations as usual.
Although we never claim that angular deformities are acceptable (regardless of the degree of acceptance), they must be individualized. To help you understand better the concept of individual aspect in deformity, let us take the example of valgus deformity of the knee where the distal part of the leg below the knee is swerved outward, about the femur, thus resulting in a knock-kneed appearance. We will also consider another case of varus deformity (an extreme inward angulation of the distal segment of a bone or joint). The knock-kneed condition can be reversed to a large extent with proper therapies and physiological methods when conducted with precision.
A young woman with slender legs with the usual valgus (the direction that the distal segment of the joint points) of the knees would find a 10° valgus deformity of the tibia cosmetically unacceptable. If that deformity were to be lowered to 5°, there are chances that the cosmetic appearance of the extremity would be acceptable. In the second case, let us take an example of an older manual worker or labourer. In this case, varus with 8° or even 10° in some instances of Varus angular deformity would be considered extremity satisfactory by the individual.
Considering these two cases, we can conclude that cosmetic appearance plays a significant role in accepting angular deformities. Their early development can often be corrected by further manipulation or by using braces developed by companies with orthopaedic and orthopaedic surgical instruments. Still, if such a method is not successful, then various other forms of treatment are readily available.
The long-lasting effects of angular deformity on neighbouring joints have been of concern to orthopaedic surgeons and spine Implants experts. Based on our long clinical experience in the orthopaedic instruments and orthopaedic surgical instruments domain, we personally believe that angular deformities in any plane that do not exceed 10° are not likely to fabricate arthritic changes in the knee, ankle, or
Talocalcaneal joint. We have never seen a patient with deformities within that range suffer from secondary osteoarthritic changes. In the 1960s, Professor Bohler, a renowned orthopaedic implants expert, shared his findings of over 15000 tibial fractures that he had treated with long-leg weight-bearing casts. He quoted that any regulations of up to 8 did not produce late arthritic changes. It was due to his findings that later experts set the limits of acceptability of angular deformities in tibial fractures at 8° in an attempt to link the functional with the aesthetic implications.
With years of experience in the orthopaedic surgical instruments business, we have seen patients with angular degrees higher than 10° (without late sequelae) who do not know the existence of deformities. A longer follow-up might probably bring about unwanted problems.
Recent findings in orthopaedic implants have confirmed no increased incidence of osteoarthritic changes in the knee and ankle after acceptance of deformities of less than 15°. The results also quoted this with an example in which there was a regular 40-year observation of a tibial fracture treated with a long leg cast that healed with 15° of valgus and recurvatum. Neither recurvatum deformity nor the knee or the ankle experienced any osteoarthritic changes.
Presently, another report on animal studies quoted that it was found that angular deformities could produce late degenerative changes in the adjacent joints. However, in this case, the expert used 30° of angulation, which is an angulation virtually out of the dominion of the clinical probability. Therefore, a study was finally of no clinical relevance.
Another Interlocking Nails study dealing with the impacts of angular deformity on knee and ankle joint stress has powerfully supported the clinical observations. The study stated that the angulations of 5 to 10° of the tibias alter the distribution of pressure at the tibiotalar joint only modestly. The posterior angular deformity was most likely to be associated with such cases.
Ortho surgical implant experts clearly say that angular deformities of the tibia of the Varus or valgus type can be compensated appropriately by the foot only if the subtalar joint is intact. In the nonexistence of motion at this level, the usual pattern of weight distribution in the foot would be distorted with the chances of increased impact over the medial or lateral aspect of the foot as per the deformity.
