Correction of severe adolescent tibia vara by a single-stage V-shaped osteotomy using Ilizarov fixator

Abstract

This study reports on the clinical experience and results of a new surgical technique for single-stage acute correction of the complex proximal tibial deformity in adolescent tibia vara using a minimally invasive surgical approach. This prospective study included 19 limbs. The mean age was 14 years. A v-shaped proximal tibial osteotomy was performed such that the first osteotomy limb was used to elevate the depressed medial tibial plateau, while the second limb osteotomy corrected the metaphyseal varum and internal rotation deformity. This acute correction was stabilized by an Ilizarov frame construct. Follow-up averaged 16.8 ± 4.4 months. Average time in the frame was 11.2 ± 1.2 weeks. All cases reached maturity, maintained their correction, and ultimately achieved union. The angle of depression of the medial tibial plateau improved from a median of 38° preoperatively to 7° postoperatively. This technique seems to provide satisfactory basis for a dependable method of correction for severe adolescent tibia vara. Level IV, Case series study, Closed Cohort Study.