Abstract
Background
Severe infantile Blount's disease can result in a multiplanar deformity of the proximal tibia with both intra-articular and metaphyseal components. Correction can represent a significant surgical challenge. We describe our results using the Taylor spatial frame for acute tibial hemiplateau elevation combined with gradual metaphyseal correction in patients with severe infantile blounts with an associated physeal bony bar.
Methods
Eight patients (10 knees) underwent tibial hemiplateau elevation and metaphyseal correction with use of the Taylor Spatial Frame between 2012–2016. We undertook a retrospective case note and radiographic review of all patients to assess clinical and radiographic outcomes. Mean age at the time of surgery of was 11.7 years and mean length of follow up was 16.8 months.
Results
At time of latest follow up all patients reported no hip, knee or ankle pain. All knees were clinically stable without lateral thrust during gait.
Improvement in radiographic parameters was seen in all patients. The mean tibiofemoral angle improved from −28.3 to 5.9 degrees post operatively. The angle between femoral condyles and the tibial shaft improved from a mean of 56.3 degrees to 90.3 degrees. The joint depression angle was also seen to improve from mean 47.4 degrees to 9.8 degrees. No significant complications were seen.
Conclusion
This technique has been shown to be an effective method of correction of the complex deformity encountered in severe infantile Blount's disease. Use of the Taylor spatial frame may provide certain advantages in comparison to previously described approaches.
Level of Evidence: Level IV (Case Series)
