Step cut “V” osteotomy for acute correction in Blount’s disease treatment: A case series

Abstract

Highlights Severe Blount’s disease results in progressive multiplanar deformity of the lower limb. Blount’s disease management should be tailored individually. Step Cut “V” Osteotomy developed by our institution in order to have more predictable result. Step Cut “V” Osteotomy provide accurate and safe correction even in severe deformity.

Acute "three-in-one" surgery for the treatment of severe Blount's disease: Surgical technique and report of two cases

“… 5 , 16 However, these devices are more expensive, time-consuming, and fraught with many complications and poor patient compliance. 2 The approach described here is, to our knowledge, the only one combining acute intra-epiphyseal and metaphyseal osteotomies as well as lateral tibial temporary hemi-epiphysiodesis; thus being named ‘three-in-one’. It is unwise to draw rigid conclusions regarding the efficacy of this approach, yet the results are very promising.…”

“…Many osteotomies were designed to address varus deformity (Oblique, V, Z, Inverted V, dome, closing and open wedge osteotomies). 1 , 2 , 3 , 4 Little attention has been paid to early correction of the medial plateau inclination, which is the other aspect of the deformity disturbing joint congruity. The posteromedial slope of the tibial plateau contributes to the varus instability and internal rotation of the limb.…”

Osteotomy treatments and post-operative fixations for Blount disease: A systematic review

“…Blount disease is an idiopathic developmental abnormality characterized by disordered endochondral ossification of medial proximal tibial physis, resulting in a multiplanar lower limb deformities with pronounced tibia vara [ 1 ]. In 1937, Blount characterized the infantile tibia vara (ITV) that is apparent before age four, and the late onset tibia vara (LOTV) that develops in adolescents before skeletal maturity [ 2 ].…”

“…Blount disease has been long studied within numerous reviews and reports, but the method of correction and fixation remains debatable. Gradual distraction osteogenesis is generally seen as better practice to manage Blount disease as it is believed to be safer and more accurate to deal with multiplanar deformities, even limb length differences [ 1 ]. However, acute correction of angular and rotational deformity provides a more practical strategy and shorter, easier monitoring [ 1 ].…”

“…Gradual distraction osteogenesis is generally seen as better practice to manage Blount disease as it is believed to be safer and more accurate to deal with multiplanar deformities, even limb length differences [ 1 ]. However, acute correction of angular and rotational deformity provides a more practical strategy and shorter, easier monitoring [ 1 ]. For late onset and severe deformities, proximal tibial osteotomy for correction regardless of the fixation method was generally suggested.…”