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Review Question - QID 175

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QID 175 (Type "175" in App Search)
A 30-year-old man presents with a distal third tibia fracture that has healed in 25 degrees of varus alignment. The patient is at greatest risk of developing which of the following conditions as a result of this malunion?

Degenerative lumbar spine changes

0%

5/1283

Ipsilateral ankle pain and stiffness

67%

858/1283

Ipsilateral hip joint degenerative changes

4%

52/1283

Contralateral hip joint degenerative changes

1%

18/1283

Ipsilateral medial knee degenerative changes

27%

342/1283

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A significant malunion of the distal tibia has important consequences for patient outcome, including pain, gait changes, and cosmesis.

The first referenced article by Milner et al looked at long-term outcomes of tibial malunions and noted that varus malunion led to increased ankle/subtalar stiffness and pain regardless of the amount of radiographic degenerative changes.

The second referenced article by Puno et al reinforced the concept of decreased functional outcomes of the ankle with tibial malunions, and noted that other lower extremity joints (ipsilateral and contralateral) do not have increased rates of degeneration from such a malunion.

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