class="Heading">Background class="Para">Torsional malalignment syndrome (TMS) is a well defined condition consisting of a combination of femoral antetorsion and tibial lateral torsion. The axis of knee motion is medially rotated. This may lead to patellofemoral malalignment with an increased Q angle and chondromalacia, patellar subluxation and dislocation. Conservative management is recommended in all but the most rare and severest cases. In these cases deformity correction requires osteotomies at two levels per limb. class="Heading">Materials and methods class="Para">From 1987 to 2002 in our institution three patients underwent double femoral and tibial osteotomy for TMS bilateral correction (12 osteotomies). All patients were reviewed at mean follow-up of 16?years. class="Heading">Results class="Para">At final follow-up no patients reported persistence of knee or hip pain. At clinical examination both lower limbs showed a normal axis and a normal patella anterior position. Pre-operative femoral version measurement showed an average hip internal rotation of 81.5° (range 80°–85°) and average hip external rotation of 27.2° (10°–40°). Thigh–foot angle measurement showed an average value of 38.6° (32°–45°). At final follow-up femoral version measurement showed an average hip internal rotation of 49° (range 45°–55°) and average hip internal rotation of 44.3° (20°–48°) (Figs.? class="InternalRef">href="#Fig1">1, class="InternalRef">href="#Fig2">2, class="InternalRef">href="#Fig3">3, class="InternalRef">href="#Fig4">4, class="InternalRef">href="#Fig5">5, class="InternalRef">href="#Fig6">6). Thigh–foot angles measurement showed an average value of 21.6° (18°–24°) outward. class="Heading">Conclusion class="Para">We recommend a clinical, radiographical and CT scan evaluation of all torsional deformity. In cases of significant deformity, internally rotating the tibia alone is not sufficient. Ipsilateral outward femoral and inward tibial osteotomies are our current recommendation for TMS, both performed at the same surgical setting.
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机译：class =“ Heading”>背景 class =“ Para”>扭转性畸形综合症（TMS）是一种明确定义的疾病，由股骨前弯和胫骨外侧扭转组成。膝盖运动轴向中间旋转。这可能导致Q角增加和align骨软化，pa骨半脱位和脱位而导致pa股畸形。除了最罕见和最严重的情况，建议在所有情况下均采取保守治疗。在这些情况下，畸形矫正需要每肢两个级别的截骨术。 class =“ Heading”>材料和方法 class =“ Para”>在我们机构中，从1987年到2002年，共接受了3例患者的手术双股和胫骨截骨术用于TMS双侧矫正（12处截骨术）。所有患者均经过平均16年的随访。 class =“ Heading”>结果 class =“ Para”>在最终随访中，没有患者报告膝盖持续存在或臀部疼痛。在临床检查中，两个下肢均显示出正常的轴和and骨前部位置。术前股骨测量显示平均髋关节内部旋转为81.5°（范围为80°–85°），平均髋关节外部旋转为27.2°（10°–40°）。大腿角度测量的平均值为38.6°（32°-45°）。在最后的股骨随访中，测量结果显示平均髋关节内部旋转度为49°（45°–55°），平均髋关节内部旋转度为44.3°（20°–48°）（图。 class =“ InternalRef “> href="#Fig1"> 1 ， class =” InternalRef“> href="#Fig2"> 2 ， class =“ InternalRef”> href="#Fig3"> 3 ， class =“ InternalRef”> href="#Fig4"> 4 ， class =“ InternalRef”> href="#Fig5"> 5 ， class =“ InternalRef”> href="#Fig6"> 6 ）。大腿脚角度测量显示向外平均为21.6°（18°–24°）。 class =“ Heading”>结论 class =“ Para”>我们建议临床，射线照相和CT扫描评估所有扭转畸形。在严重畸形的情况下，仅内部旋转胫骨是不够的。目前，我们建议对同侧外侧股骨和内侧胫骨截骨术均在相同的手术环境中进行。
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