Indications for Osteotomy of the Tibia in Children

Dietz, Frederick R.; Merchant, Thomas C.

doi:10.1097/01241398-199007000-00011

Cited by 8 publications

(6 citation statements)

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“…Varus osteotomy and stapling in the proximal tibia or the distal femur for genu valgum have been reported [ 1,6,19,22]. Two patients who underwent varus osteotomy of the tibia with simple partial excision of the fibula for severe genu valgum suffered relapse (Fig.…”

Section: Discussionmentioning

confidence: 97%

Multiple osteocartilaginous exostosis

Ozaki

Kawai

Sugihara

et al. 1996

Arch Orthop Trauma Surg

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Deformity of the lower extremities in 26 patients with multiple cartilaginous exostosis was examined radiologically. Follow-up periods ranged between 3 and 33 years (mean 10.3 years). Twenty-four patients had deformity of the joints. A femoral neck-shaft angle (FNA) of more than 150 degrees was noted in 14 patients (26 of 51 hip joints) at diagnosis. After approximately 10 years of age, the FNA tended to decrease. Eleven patients (22 of 52 knee joints) had genu valgum (the femorotibial angle < mean -2 SD of normal control) which was caused by valgus deformity of the distal femur in one-third of the patients and that of the proximal tibia in two-thirds. Fifteen of 21 patients (29 of 42 joints) had valgus deformity of the ankle (antero-posterior mortise angle of the ankle > 94 degrees), and in half of them, the valgus deformity progressed with growth. Two patients (aged 10 and 11 years) underwent varus osteotomy of the tibia with partial excision of the fibula. However, their deformity relapsed. Surgical treatment for hip deformity is unnecessary during the growth stage. Progressive deformity of the knee and ankle should be detected in an early stage, and the surgical indication has to be examined.

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Section: Discussionmentioning

confidence: 97%

Multiple osteocartilaginous exostosis

Ozaki

Kawai

Sugihara

et al. 1996

Arch Orthop Trauma Surg

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“…The principles of deformity analysis are identical whether applied for guided growth or corrective osteotomies [ 8 , 9 ]. It is important to decide whether to address the femur, the tibia or both.…”

Section: Methodsmentioning

confidence: 99%

Guided growth: 1933 to the present

Stevens¹

2006

Strategies in Trauma and Limb Reconstruction

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While osteotomies are necessary for rotational correction and limb lengthening, angular correction or moderate length inhibition may be achieved by other, less invasive means. Several techniques of epiphysiodesis have evolved, enabling gradual correction of angular correction and/or length equalisation through guided growth. This manuscript comprises a historical and comparative review of those techniques. The 8-plate method of guided growth affords the opportunity to provide a tension band (rather than compression) that expedites angular correction, compared to stapling or transphyseal screws, which rely upon the principle of compression. When applied to each side of a given physis, longitudinal growth is inhibited, in the same fashion as stapling or epiphysiodesis. The physis and periosteum are spared any direct insult, thus making this a reversible process, suitable for use in younger children. The 8-plate is simple to insert and, compared to staples or transphyseal screws, easy to remove.

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“…Patients, who have persistent varus deformity without evidence of improvement after one year of orthosis use, presenting with stage 3 involvements, are treated with a proximal tibial corrective osteotomy. An osteotomy performed before age 8 on a patient with stage 4 or less Blount's is usually sufficient to correct the deformity [16]. Nine tibiae with Blount's disease were treated in Rab series, with a single-plane oblique proximal tibial osteotomy allowing simultaneous correction of varus and internal rotation.…”

Section: Discussionmentioning

confidence: 99%

Modifies Oblique Proximal Tibial Osteotomy for Deformity Correction of Tibia Vara (Blount Disease)

Elzohairy¹

2012

Orthop Muscul Syst

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Background: In Blount's disease, there is a complex three-dimensional deformity which typically includes varus, internal rotation, and (sometimes) procurvatum. The best way to obtain correction is with simple procedure carried out as high in the tibia as possible to promote rapid union, quick remodeling, and with minimal proximal shaft deformity. Patients and methods: 17 patients with tibia vara underwent corrections of deformity associated with tibia vara by modified Rab proximal tibial oblique osteotomy at our hospital. In twelve patients the deformity was bilateral and it was unilateral in the other five patients, with a total of 29 tibiae. They were ten boys and seven girls with a mean age at surgery of 3 years 6 months (range, 3 years 2 months to 4 years 11 months). The patients were in stage III of the Langenskiöld classification (1952) of the disease. Results: According to Schoenecker's criteria, 100% of the patients in this study had a good result. Radiologically healing was achieved in all osteotomies with the desired correction of deformity within twelve weeks in all the 17 patients with no complication. Conclusion: The modified Rab oblique proximal tibial has the advantage of allowing both angular and rotational correction with a high degree of success.

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Indications for Osteotomy of the Tibia in Children

Cited by 8 publications

References 0 publications

Multiple osteocartilaginous exostosis

Multiple osteocartilaginous exostosis

Guided growth: 1933 to the present

Modifies Oblique Proximal Tibial Osteotomy for Deformity Correction of Tibia Vara (Blount Disease)

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