Azhar dome physioclasis: A new surgical technique of treating patients with late presenting blount's disease

Abstract

Introduction: Surgical treatment of patients with multi-planar deformity secondary to Late Presenting Blount disease (LPBD). Is there a new method for acute deformity correction of tibial deformity in patients with LPBD? The new method entailed acute deformity correction of the deformity by manual rotation of the deformed limb relative to the CORA in the physis itself. Patients and Methods: A prospective case study performed on two patients. First patient was eleven years old boy with LPBD and bilateral affection. Patient's height was 127cm, and weight was 60 kg; with BMI was 37.2 kg/m2. Both sides were done, left sided correction preceded the right side by 6 weeks. The second patient was twelve years old female. Her height was 145cm, and weight was 67kg with BMI 31.8 kg/ m2. Results: Acute correction of the varus, procurvatum and internal rotation was achieved intraoperatively with corrected mechanical axis. Average follow up was 20 months. No complications encountered in either limb. Conclusion: “Dome Physioclasis” is a new novel surgical technique that allows acute tibial multi-plane deformity correction in patients with LPBD. This method is suitable for selected cases where patients complain from severe deformity and near skeletal maturity. Future more experience in the technique may improve its understanding.