Cozens phenomenon of proximal tibia

Abstract

Introduction: The incidence of all proximal tibial fractures in children is 5 to 6/100,000.1It has numerous complications, such as angular deformity and leg-length discrepancy. Usually proximal tibial metaphyseal fractures are known to result in late valgus deformity. Patient Assesment: Patient assessment involves clinical and radiological examination using plain radiography of both tibias, anteroposterior and lateral view. Management: If spontaneous correction of the deformity is not observed and there is sufficient growth remaining, hemi-epiphysiodesis can offer the optimal solution. Permanent epiphysiodesis, be it open or percutaneous, can only be used in those approaching skeletal maturity, recognizing that, if timing is incorrect, this can result in over- or under-correction and leg length discrepancy. Conclusion: Cozen’s phenomenon is an unpredictable, uncommon and potentially under diagnosed condition. It is now possible to safely correct the valgus deformity with minimal surgery. Guided growth, tethering the proximal medial tibial physis with an extra-periosteal, nonlocking plate, and two screws are recommended.