Combined distal tibial rotational osteotomy and proximal growth plate modulation for treatment of infantile Blount's disease

作     者：Amr A Abdelgawad 

作者机构：Department of Orthopedic Surgery Texas Tech University Health Science Center at El Paso El Paso TX 79905 United States 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2013年第4卷第2期

页      面：90-93页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Infantile Blount’s disease Tibia vara Growth modulation Eight plate Hemi-epiphysiodesis Rotational osteotomy Genu varum Lateral tension plate Distal tibial osteotomy External rotation osteotomy Guided growth 

摘      要：Infantile Blount s disease is a condition that causes genu varum and internal tibial torsion. Treatment options include observation, orthotics, corrective osteotomy, elevation of the medial tibial plateau, resection of a physeal bar, lateral hemi-epiphysiodesis, and guided growth of the proximal tibial physis. Each of these treatment options has its disadvantages. Treating the coronal deformity alone(genu varum) will result in persistence of the internal tibial torsion(the axial deformity). In this report, we describe the combination of lateral growth modulation and distal tibial external rotation osteotomy to correct all the elements of the disease. This has not been described before for treatment of Blount s disease. Both coronal and axial deformities were corrected in this patient. We propose this combination(rather than the lateral growth modulation alone) as the method of treatment for early stages of Blount s disease as it corrects both elements of the disease and in the same time avoids the complications of proximal tibial osteotomy.