TITLE:
Combined Antero-Posterior Inverted-U Metaphyseal and Open-Wedge Medial-Epiphyseal Osteotomy for Advanced Blount Disease
AUTHORS:
Alfred O. Ogbemudia, Anirejuoritse Bafor, Ehimwenma J. Ogbemudia, Edwin Edomwonyi
KEYWORDS:
Blount Disease, Double Osteotomy, Tibial Osteotomy, Blount Disease
JOURNAL NAME:
Surgical Science,
Vol.6 No.4,
April
9,
2015
ABSTRACT: Background: Blount disease is frequently associated with deformities that
may not be adequately corrected by a single metaphyseal osteotomy. This study
evaluated the outcome of a combined metaphyseal and epiphyseal osteotomy in
severe cases. Methods: We prospectively evaluated the outcome of combining the
antero-posterior inverted-U metaphyseal osteotomy with a medial open-wedge
hemi-epiphyseal osteotomy in eighteen patients (27 tibiae) with Stage IV to VI
Blount disease. Results: The average age of patients was 9 years (ranging from
5 to 17). The tibio-femoral angle improved from 43° varus (Range: 34° - 78°) to
2° varus (Range: 5° valgus to 8° varus). The metaphyseal-diaphyseal angle
improved from 36° to 8° varus. Internal tibial torsion improved from 39° to 2°.
All the patients were able to achieve 110°of knee flexion in a year.
Conclusion: In conclusion, the combined metaphyseal and epiphyseal osteotomy
satisfactorily corrected tibio-femoral and metaphyseal-diaphyseal varus and
internal tibial torsion without recurrence in patients with severe Blount
disease. Level of Evidence: IV.