Treatment of severe early onset Blount's disease by an intra-articular and a metaphyseal osteotomy using the Taylor Spatial Frame

Abstract

Purpose Severe Blount's disease results in a multiplanar deformity of the lower limb. The mechanical axis is disrupted, there is a rotational deformity, and also shortening of the limb. A depression of the medial tibial plateau causes joint incongruity and instability. The purpose of this study is to review the results of treatment addressing all the aspects of the deformity. Methods Four patients were treated for severe Blount's disease. The index procedure consisted of a medial tibial plateau elevating osteotomy, a lateral tibial and proximal fibular epiphysiodesis, a proximal tibial metaphyseal osteotomy, and the application of the Taylor Spatial Frame programmed for correction of varus, rotation and shortening, and preemptive lengthening to compensate for growth arrest. Results Mechanical axis was corrected from a mean 23°( 13°-30°) to 0°in three patients and 6°valgus in 1. Tibias were lengthened by 1-4 cm. At follow-up, the mechanical axis was 0°in two patients and 7°varus in two. The overlengthening was diminishing as planned. Conclusions The double osteotomy and Taylor Frame correction was found to be accurate, safe, and effective for multiplanar deformity correction in severe Blount's disease.

Intentional Deformation and Closure of Soft Tissue Defect in Open Tibial Fractures With a Taylor Spatial Frame—A Simple Technique

“…8,9,[21][22][23][24][25][26] Manner et al 27 compared IRFs and TSFs in correcting complex limb deformities and found TSF to be superior to IRF. Several studies confirm the accuracy of this method in trauma and developmental deformities.…”

Management of neglected Blount disease using double corrective tibia osteotomy and medial plateau elevation

“…The use of the Ilizarov Frame [15][16][17], the Taylor Spatial Frame [18][19][20], and a Multi-Axial Correction external fixation system [21] are modern therapeutical options, although significantly more expensive than our procedure. These systems enable gradual correction [20], in contrast to our cases, for whom correction was imminent.…”

Severe Infantile Blount’s Disease in Kumasi, Ghana: A Case Report

“…Tibia vara is a disease that involves the epiphysis, physis and the metaphysis [3,8,9]. Disruption of the normal enchondral ossification in the posteromedial aspect of the proximal metaphysis occurs with defective growth of the posteromedial physis [10,11]. The disruption of growth at the proximal medial tibial physis occurs due to abnormal stresses on the epiphysis in response to the Heuter-Volkman law which states that increased pressure on an epiphysis inhibits growth [5].…”

“…The late stages of the infantile disease may be accompanied by depression of the medial tibial plateau in addition to the varus and the internal torsion of the tibia [11].…”