The effect of tibial rotational deformity on ankle joint loadings: A finite element analysis.

Authors

Alp Er Tunga Bolukbasi, Onur Kocadal, Burak Cagri Aksu, Korcan Yuksel, Kaan Yardimci

Published in

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons. Sep 08, 2026. Epub Sep 08, 2026.

Abstract

Tibial shaft fractures are common, and malrotation is a frequent complication after intramedullary nailing. This study evaluated the effect of tibial malrotation on ankle joint loading using finite element analysis.
Finite element models were created from Visible Human Project CT data. A distal one-third transverse tibial shaft fracture was fixed with an intramedullary nail. Seven models were analyzed: neutral, 5°, 15°, and 25° internal rotation (IR), and 5°, 15°, and 25° external rotation (ER). A 2500 N axial load was applied, and tibiotalar cartilage and implant stresses were assessed.
Tibiotalar cartilage loading increased with malrotation, peaking in the 25° IR model. Internal rotation consistently produced greater stresses than equivalent external rotation.
Tibial malrotation increases ankle cartilage loading after intramedullary nailing. Internal rotation causes greater biomechanical changes than external rotation and may increase the risk of ankle arthrosis.

PMID:
42728164
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.

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