Allison Cooper Scott1. 1. Shriners Hospital for Children, Houston, TX, USA. ascott@shrinenet.org
Abstract
BACKGROUND: Growth manipulation has had increasing popularity in the treatment of lower extremity angular deformities in children. This paper discusses the use of growth manipulation for the treatment of infantile Blount disease as an alternative to proximal tibial osteotomy. METHODS: A retrospective chart and radiographic review was carried out for 12 children (18 limbs) who had treatment of infantile Blount disease with application of lateral proximal tibial tension band plates. Some children also had distal femoral lateral plates applied. Serial radiographs were measured to show response to growth manipulation. RESULTS: The success rate of growth manipulation in this group was 89%. Failures and delayed correction were attributed to wound infection that required plate removal and broken screws. Some recurrence of varus has occurred in a few patients. CONCLUSIONS: Growth manipulation is an effective means of treating infantile Blount disease in appropriate patients. Patients must be monitored for screw breakage after surgery. After removal of the plates, the risk of recurrent varus is attributed to the poor growth potential of the proximal medial tibial physis. LEVEL OF EVIDENCE: Therapeutic study, Level IV.
BACKGROUND: Growth manipulation has had increasing popularity in the treatment of lower extremity angular deformities in children. This paper discusses the use of growth manipulation for the treatment of infantile Blount disease as an alternative to proximal tibial osteotomy. METHODS: A retrospective chart and radiographic review was carried out for 12 children (18 limbs) who had treatment of infantile Blount disease with application of lateral proximal tibial tension band plates. Some children also had distal femoral lateral plates applied. Serial radiographs were measured to show response to growth manipulation. RESULTS: The success rate of growth manipulation in this group was 89%. Failures and delayed correction were attributed to wound infection that required plate removal and broken screws. Some recurrence of varus has occurred in a few patients. CONCLUSIONS: Growth manipulation is an effective means of treating infantile Blount disease in appropriate patients. Patients must be monitored for screw breakage after surgery. After removal of the plates, the risk of recurrent varus is attributed to the poor growth potential of the proximal medial tibial physis. LEVEL OF EVIDENCE: Therapeutic study, Level IV.
Authors: Julia Sattelberger; Hauke Hillebrand; Georg Gosheger; Andrea Laufer; Adrien Frommer; Sebastian Appelbaum; Ahmed Abdul-Hussein Abood; Martin Gottliebsen; Ole Rahbek; Bjarne Moller-Madsen; Robert Roedl; Bjoern Vogt Journal: Acta Orthop Date: 2021-01-19 Impact factor: 3.717
Authors: Ki Hyuk Sung; Chin Youb Chung; Kyoung Min Lee; Seung Yeol Lee; In Ho Choi; Tae-Joon Cho; Won Joon Yoo; Moon Seok Park Journal: Biomed Res Int Date: 2014-09-03 Impact factor: 3.411