Correction of severe adolescent tibia vara by a single-stage V-shaped osteotomy using Ilizarov fixator

Hegazy, Mohamed; Abdelatif, Nasef Mohamed Nasef; Mahmoud, Mostafa; Khaled, Sherif A.; Abdelazeem, Ahmed Hazem; El-Sayed, Mohamed; Karim, Mahmoud M. Abdel; Elshazly, Ossama

doi:10.1007/s12570-015-0291-5

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…3a, b). Medial tibial plateau depression (MTPD) [33] and posterior proximal tibial angle (PPTA) were also measured to evaluate the morphology of the tibia plateau (Fig. 4a, b).…”

Section: Methodsmentioning

confidence: 99%

Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Higuchi

Koseki

Yonekura

et al. 2019

BMC Musculoskelet Disord

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Background The purpose of this study was to compare radiological features between high tibial osteotomy (HTO) and tibial condylar valgus osteotomy (TCVO), in order to define the radiological indication criteria for TCVO. Methods Thirty-two cases involving 35 knees that had undergone HTO and the same number that had undergone TCVO for knee osteoarthritis were retrospectively evaluated. Characteristics of both groups did not differ significantly. Lower limb alignment, bone morphology, joint congruity, and joint instability were measured in standing full-length leg and knee radiographs obtained before and after surgery. Results Radiological features in the TCVO group included greater frequencies of advanced knee OA grade, varus lower limb malalignment, depression of the medial tibial plateau, and varus-valgus joint instability compared to the HTO group before surgery. However, tibial morphology, alignment of the lower limb, and joint instability improved to comparable levels after surgery in both groups. Conclusions TCVO appears preferable in cases with advanced knee OA, destroyed or inclined medial tibial plateau, widened and subluxated lateral joint, and high varus-valgus joint instability.

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“…3a, b). Medial tibial plateau depression (MTPD) [33] and posterior proximal tibial angle (PPTA) were also measured to evaluate the morphology of the tibia plateau (Fig. 4a, b).…”

Section: Methodsmentioning

confidence: 99%

Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Higuchi

Koseki

Yonekura

et al. 2019

BMC Musculoskelet Disord

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“…In addition, it is applied percutaneously without periosteal disruption. Furthermore, an external fixator is adjustable and any residual degree of under or overcorrection can be managed through the device at the bedside or at the early outpatient follow-up reviews [ 14 – 16 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Acute correction of severe complex adolescent late-onset tibia vara by minimally invasive osteotomy and simple circular fixation: a case series with 2-year minimum follow-up

Zein

Elhalawany

Ali

et al. 2021

BMC Musculoskelet Disord

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Background Despite multiple published reviews, the optimum method of correction and stabilisation of Blount’s disease remains controversial. The purpose of this study is to evaluate the clinical and radiological outcomes of acute correction of late-onset tibial vara by percutaneous proximal tibial osteotomy with circular external fixation using two simple rings. Weighing up the pros and cons and to establish if this method would be the method of choice in similar severe cases especially in a context of limited resources. Methods This study was conducted between November 2016 and July 2020. We retrospectively reviewed the clinical notes and radiographs of 30 patients (32 tibiae) who had correction of severe late-onset tibia vara by proximal tibial osteotomy and Ilizarov external fixator. The mean age at the time of the operation was 16.6 (± 2.7) years (range 13–22). Results The mean proximal tibial angle was 65.7° (± 7.8) preoperatively and 89.8° (± 1.7) postoperatively (p < 0.001). The mean mechanical axis deviation improved from 56.2 (± 8.3) preoperatively to 2.8 (± 1.6) mm postoperatively (p < 0.001). The mean femoral-tibial shaft angle was changed from –34.3° (± 6.7) preoperatively to 5.7° (± 2.8) after correction, with degree of correction ranging from 25° to 45°. Complications included overcorrection (three cases 9%) and pin tract infection (eight cases 25%). The mean Hospital for Special Surgery knee scoring system (HSS) improved from 51.03 (± 11.24) preoperatively to 94.2 (± 6.8) postoperatively (p < 0.001). The mean length of follow up period 33.22 (± 6.77) months, (rang: 25–46 months). At final follow up, all patients had full knee range of motion and normal function. All cases progressed to union and there were no cases of recurrence of deformity. Conclusion This simple procedure provides secure fixation allowing early weight bearing and early return to function. It can be used in the context of health care systems with limited resources. It has a relatively low complication rate. Our results suggest that acute correction and simple circular frame fixation is an excellent treatment choice for cases of late-onset tibia vara, especially in severe deformities.

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“…Patients' satisfaction: Patients' satisfaction was reported in only three studies. In the Hegazy et al [37] 's study, at the end follow-up, every patient expressed satisfaction with their operation. In Aly et al [38] , six months after the cast was taken off and full weight bearing was achieved postoperatively, there was a notable improvement in the Lysholm score, with 15 patients scoring excellent [78.9%], Two good [10.5%], one fair [5.2%], and one poor [5.2%].…”

Section: Quality Assessmentmentioning

confidence: 95%

Outcome of Different Surgical Techniques for Management of Adolescent Tibia Vara; Systematic review

Rizk,

Abulsoud,

Shamma

2023

International Journal of Medical Arts

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Article informationBackground: Adolescent tibia vara [ATV] is a multiplanar malformation that can cause diminished function and permanent damage. ATV is believed to be a multifaceted developmental disease of the proximal tibia, which results in a malformation of the varus and procurvatum. In genetically vulnerable individuals, this disorder may also be partially attributed to mechanical strain.The Aim of the work: This pooled analysis goal is to evaluate and compile the data about the efficacy and complications of the most popular surgical lines of treatment of tibia vara in adolescents: osteotomy, Ilizarov, and hemiepiphysiodesis.Methods: Considering the search strategy, a literature study was conducted from 2010 to 2020 in the Web of Science, PubMed, Scopus, and Cochrane datasets. Studies were selected if it included. This systematic review had 15 published papers with a total sample size of 357 limbs.Results: Temporal hemiepiphysiodesis is used effectively to treat mild/moderate ATV in patients with sufficient growth. Temporal hemiepiphysiodesis has been linked to an elevated failure and recurrence rate of approximately 28.4%. In managing ATV, a modified Rab osteotomy with minimal fixation using two or three screws yields encouraging outcomes. However, the post-operative time of healing is affected by BMI. Thus, it's not the best choice for obese patients with ATV. For correcting mild to moderate ATV, medial opening wedge high tibial osteotomy-with or without a bone graft-is an appropriate approach. Conclusion:The best surgical technique for adolescent tibia vara depends on the patient's circumstances. Osteotomy is generally preferred over hemiepiphysiodesis due to its lower recurrence rate. The use of simple circular frame fixation with proximal tibial osteotomy is the ideal option for treating neglected ATV, mainly when the patient is obese and has severe deformities.

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Correction of severe adolescent tibia vara by a single-stage V-shaped osteotomy using Ilizarov fixator

Cited by 4 publications

References 17 publications

Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Comparison of radiological features of high tibial osteotomy and tibial condylar valgus osteotomy

Acute correction of severe complex adolescent late-onset tibia vara by minimally invasive osteotomy and simple circular fixation: a case series with 2-year minimum follow-up

Outcome of Different Surgical Techniques for Management of Adolescent Tibia Vara; Systematic review

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