Amount of Correction of Torsional Deformity in Blount's Disease After Coronal Plane Deformity Correction by 8 Plate Hemiepiphysiodesis

Amount of Correction of Torsional Deformity in Blount's Disease After Coronal Plane Deformity Correction by 8 Plate Hemiepiphysiodesis

Amount of Correction of Torsional Deformity in Blount's Disease After Coronal Plane Deformity Correction by 8 Plate Hemiepiphysiodesis

This study is to evaluate the amount of correction of torsional deformity in Blount's disease after coronal plane deformity correction by 8 plate hemiepiphysiodesis.

Blount disease, also known as pathologic tibia vara , is an acquired growth disorder of the medial proximal tibial physis and epiphysis that results in a three-dimentional deformity of the lower limb (a progressive varus ,procurvatum and internal rotaion deformity of the tibia). Blount disease can be classified as infantile, or early onset form, which appears before the age of four years, juvenile, which appears between four and ten years and adolescent, or late onset form, which appears in children older than ten years. Surgical treatment options include tibial osteotomies with either acute or gradual correction and proximal lateral tibial hemiepiphysiodesis (guided growth) the latter being less invasive and with significantly lower rate of major complications. Guided growth by 8 plate hemiepiphysiodesis is commonly used to correct coronal plane deformity around the knee. Since its introduction by Stevens in 2007 many studies have demonstrated the efficacy, safety and advantages of tension band plating in the paediatric age group as an alternative to corrective osteotomy. The marked intoeing seen in Blount disease may be caused by internal tibial torsion, femoral anteversion or metatarsus adductus ..yet, there is no enough available literature studies evaluating the amount of correction of tortional deformity after coronal plane deformity correction by 8 plate hemiepiphysiodesis. This is the question of this study and we are trying to answer it by measuring the torsional plane deformity after achieving full correction of coronal plane deformity by 8 plate hemiepiphysiodesis.

Skeletally immature patients over 2.5 years of age and less than 12 years of age who presented with pathologic tibia vara.( Langenskiöld type 1,2and 3) associated with intoeing.

The amount of correction of torsional deformity in patients with Blount's disease after coronal plane deformity correction by 8 plate hemiepiphysiodesis.

Inclusion Criteria: Skeletally immature patients over 2.5 years of age and less than 12 years of age who presented with pathologic tibia vara.( Langenskiöld type 1,2and 3) associated with intoeing. Exclusion Criteria: Skeletal maturity. Epiphyseal dysplasia. Metabolic and neurologic disorders. previous trauma. Patients younger than 2.5 years and older than 12 years old

Ozdemir E, Emet A, Ramazanov R, Yilmaz G. Correction of coronal plane deformities around knee in children with two-hole tension band plates. Jt Dis Relat Surg. 2021;32(1):177-184. doi: 10.5606/ehc.2021.78879. Epub 2021 Jan 6.

Heflin JA, Ford S, Stevens P. Guided growth for tibia vara (Blount's disease). Medicine (Baltimore). 2016 Oct;95(41):e4951. doi: 10.1097/MD.0000000000004951.