Malrotation after locked intramedullary tibial nailing: Three case reports and review of the literature

Background. Malrotation after interlocked tibial nailing is rarely documented. Methods: We report the cases of three patients who incurred symptomatic rotational deformities after closed intramedullary nailing for low-energy spiral fractures of the distal third of the tibia. Results: Two patients elected surgical correction, with excellent clinical results. Conclusion: Malrotation may cause functional deficits, but the long-term consequences of rotational deformities in the tibia have not been thoroughly studied. Malrotation after tibial nailing is probably more common than reported. Intraoperative comparison with the uninjured leg may be the best means available for avoiding this postoperative complication.