Mark Eidelman1, Viktor Bialik, Alexander Katzman. 1. Pediatric Orthopedics Unit, Rambam Health Care Campus, and Faculty of Medicine, Technion-Israel Institute of Technology, P.O. Box 9602, 31096, Haifa, Israel, markeid@yahoo.com.
Abstract
BACKGROUND: The standard treatment of adolescent Blount disease includes proximal tibial osteotomy and osteotomy of the fibula. Some believe that the fibula should also be fixed to prevent migration and subluxation. The purpose of the current study was to examine the results of treatment of patients with adolescent tibia vara treated by tibial osteotomy and Taylor spatial frame (TSF) without fibular osteotomy. METHODS: Correction of deformities was performed on eight patients (ten tibias) with adolescent Blount disease using TSF. The fibula was not osteotomized in any patient and was not fixed in the last five patients. RESULTS: All patients had precise anatomical correction of deformities and no problems related to the fibula occurred during or after correction. CONCLUSION: Based on our experience we believe that placement of the origin at the level of the proximal tibial fibular joint in conjunction with external fixation eliminates the need for fibular osteotomy and the potential morbidity of this procedure in patients with mild to moderate tibia vara.
BACKGROUND: The standard treatment of adolescent Blount disease includes proximal tibial osteotomy and osteotomy of the fibula. Some believe that the fibula should also be fixed to prevent migration and subluxation. The purpose of the current study was to examine the results of treatment of patients with adolescent tibia vara treated by tibial osteotomy and Taylor spatial frame (TSF) without fibular osteotomy. METHODS: Correction of deformities was performed on eight patients (ten tibias) with adolescent Blount disease using TSF. The fibula was not osteotomized in any patient and was not fixed in the last five patients. RESULTS: All patients had precise anatomical correction of deformities and no problems related to the fibula occurred during or after correction. CONCLUSION: Based on our experience we believe that placement of the origin at the level of the proximal tibial fibular joint in conjunction with external fixation eliminates the need for fibular osteotomy and the potential morbidity of this procedure in patients with mild to moderate tibia vara.
Authors: Soo-Sung Park; J Eric Gordon; Scott J Luhmann; Matthew B Dobbs; Perry L Schoenecker Journal: J Bone Joint Surg Am Date: 2005-10 Impact factor: 5.284