CORRECTION OF ANGULAR DEFORMITY IN ADOLESCENTS BY AN OPEN WEDGE OSTEOTOMY TECHNIQUE

Abstract

The purpose of this paper was to evaluate the early results of a new technique for correction of angular deformity in adolescents.

A retrospective review of all patients and radiographs undergoing an open wedge technique of corrective osteotomy employing a special plate designed to keep the osteotomy open at a precise amount was carried out.

From 2000–2005, eleven patients have been treated by the author using this technique. Indications for surgery included adolescent Blount’s disease or Tibia Vara in eight cases, growth arrest after fracture of the proximal tibia in one case, distal tibia in one case and developmental genu valgum in one case. The mechanical axis was restored to normal in ten of the eleven cases. One patient with adolescent Blount’s disease remained in slight varus despite the maximum available correction of 22.5 degrees. All patients healed radiographically in eight to ten weeks. Two patients have had their plates and screws removed after union of the osteotomy because of the high profile construct.

Excellent results can be achieved for correction of angular deformity in adolescents with use of a special plate designed for an open wedge technique. Attention to preserving the opposite cortex at the time of the osteotomy is critical to the success of the procedure. A maximum of approximately 20 degrees of correction is possible with this technique. Early union of the osteotomy and restoration of function give this technique specific advantages over other methods.