A 34-year-old motorcyclist sustains a closed tibial shaft fracture. Radiograph shows >50% cortical contact but 10° of varus angulation. According to the principle of acceptable reduction for tibial shaft fractures, which of the following is BEYOND acceptable limits?
- A 5° of rotational deformity
- B 1 cm of shortening
- C 10° varus angulation ✓
- D 5° sagittal angulation
Correct answer: C. 10° varus angulation
Explanation
Acceptable reduction parameters for tibial shaft fractures include: <5° of varus/valgus angulation, <10° of sagittal angulation, <10° of rotational deformity, and <1 cm shortening. Ten degrees of varus (coronal plane) exceeds the acceptable 5° limit and predisposes to lateral compartment overload and ankle arthrosis. Options B, C, and D all fall within standard acceptable ranges.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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