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Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 385 - 385
1 Sep 2005
Aner A Lakstein D Copeliovitch L
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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 Journal of Bone & Joint Surgery British Volume
Vol. 66-B, Issue 3 | Pages 331 - 333
1 May 1984
Axer A Aner A

This paper describes a new technique for greater trochanteric hip arthroplasty in which the femur is divided at the subtrochanteric level and the upper fragment rotated through 180 degrees to place the greater trochanter deeply in the acetabulum; with the lower limb in the weight-bearing position the fragments are then fixed with a short intramedullary nail. This operation was carried out in a boy aged 4 years 6 months in whom the femoral head and neck had been destroyed by septic arthritis. Ten years later leg-lengthening was performed. When reviewed at the age of 20, he had a stable hip, a satisfactory range of painless movement, and shortening of only 2.5 cm; he could walk and run for long distances with only a slight abductor lunch.