Abstract
This study reviews our 13-years experience with Haas’s multiple-longitudinal osteotomy technique for correction of tibial deformities in children. In this procedure multiple longitudinal bi-cortical osteotomies are made parallel in the proximal tibia. The deformity is corrected by applying moderate force in the desired plane. Fixation is achieved with either a long cast or with “pins-in-plaster”.
Sixty osteotomies were performed in 37 children. Thirty-five cases had internal tibial torsion (ITT), 11 had external tibial torsion (ETT) and 14 had a Tibia Vara deformity. Twenty-one cases had Spastic Cerebral Palsy and 15 cases were associated with Clubfeet. One boy had bilateral tibia vara associated with SMED (Spondylo-meta-epiphyseal dysplasia). Twenty-two (36/7%) of the deformities had no underlying musculoskeletal conditions.
Thigh-foot angles were corrected by a mean of 24° for ITT and −28° for ETT. Mean correction for tibia vara was 20°. Average anesthesia time for unilateral cases was 47 minutes. No neurologic or infectious complications, postoperative fractures or physeal damage occurred. There was one case of delayed union and 1 case of postoperative antecurvatum deformity. All 7 cases of postoperative recurrent deformities were associated with CP or SMED.
This technique is a simple, safe and efficient method for correcting tibial torsional and varus deformities for both healthy children and those with underlying conditions. It allows accurate alignment of different deformities with an uniform osteotomy technique, which preserves bone continuity and provides inherent stability, thus avoiding the use of internal fixation.
The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.
