The Journal of Bone and Joint Surgery, Vol 74, Issue 3 342-350, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Adolescent tibia vara: alternatives for operative treatment
RC Henderson, GJ Kemp and WB Greene
University of North Carolina School of Medicine, Chapel Hill.
We reviewed the cases of fifteen obese patients (twenty-one extremities)
who had had adolescent tibia vara and had been followed for at least two
years. Of the nine patients (eleven extremities) who had been initially
managed with lateral tibial hemiepiphyseodesis, eight (ten extremities)
were skeletally mature at the time of the review (mean duration of
follow-up, five years). The mechanical alignment was judged to be excellent
in three of these ten extremities, fair in three, and poor in four.
Excellent mechanical alignment was defined as a value within the reported
normal range of 5 degrees of varus to 2 degrees of valgus. A poor result
was defined as alignment that was more than 5 degrees outside the normal
range. After secondary operative procedures, three of the extremities for
which the result had been poor and one for which it had been fair had
excellent alignment. Five of the nine patients had bilateral involvement.
Two of them were managed with bilateral tibial hemiepiphyseodesis; two,
with contralateral proximal tibial osteotomy; and one had a mild deformity
on the contralateral side that was not treated. Six extremities in six
patients (two of whom had a contralateral hemiepiphyseodesis) were managed
primarily with proximal tibial osteotomy and were evaluated an average of
seven years postoperatively. Two additional patients were managed with
proximal tibial osteotomy because of residual varus deformity after the
hemiepiphyseodesis.(ABSTRACT TRUNCATED AT 250 WORDS)
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