Abstract
PurposeOblique proximal tibial osteotomy is a useful option for correcting deformity associated with Blount’s disease (tibia vara). Safe, adequate correction depends on technical issues that have evolved since the original description of the procedure.MethodsRetrospective review of surgical experience.ResultsThe refinement of osteotomy plane orientation, based on the distal rather than the proximal tibia, reduces the likelihood of procurvatum after surgery. The stability of the osteotomy is enhanced by an improved screw fixation technique. The risk of compartment syndrome is low if prophylactic partial fasciotomy is performed concurrently. Avoidance of spinal or regional block anesthesia minimizes the possibility of failure to detect post-operative compartment syndrome.ConclusionsImprovements in the technical execution of oblique proximal tibial osteotomy enhances the correction and predictability of the procedure.
Highlights
Oblique proximal tibial osteotomy is a surgical option for the correction of deformity associated with the tibia vara (Blount’s disease), especially when significant internal tibial torsion is present
Its main advantages are the maintenance of significant cancellous bone contact while correcting deformities in two planes, and the excellent cosmetic appearance afforded by both the bi-planar correction and the lateral translation of the distal fragment [1, 2]
The lateral translation occurs because the osteotomy rotates near the center of the knee and not at the location of the osteotomy site itself (Fig. 1)
Summary
Oblique proximal tibial osteotomy is a surgical option for the correction of deformity associated with the tibia vara (Blount’s disease), especially when significant internal tibial torsion is present. The exact orientation of an oblique osteotomy is critical to the success of the correction of multi-planar deformity. In Blount’s disease, the deformity typically includes varus, internal rotation, and (sometimes) procurvatum.
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