Complete Closing Wedge Osteotomy for Correction of Blount Disease (Tibia Vara): A Technique.

ABSTRACT

Treatment of Blount disease (tibia vara) can be daunting in adolescents because of their obesity. The goals in performing osteotomy for Blount disease are to correct the deformity, restore joint alignment, preserve leg length, and prevent recurrent deformity and other complications, such as neurovascular injury, nonunion, and infection. In this article, we report on our treatment of 9 limbs in 8 patients (age range, 13-17 years) with Blount disease. In each case, we performed an oblique complete closing wedge osteotomy of the tibia fixed with a compression plate with oblique screw and a fibular osteotomy. Mean body mass index was 38. In 2 patients, an external fixator (instead of a cast) was used after surgery to increase stability. Mean correction was 26°. The cast was removed at 6 weeks. A hinged knee brace was worn for another 6 weeks. Return to normal activities was allowed after 4 months. The described method, using a closing wedge tibial osteotomy and an oblique fibular osteotomy, is practical and safe and has reproducible results.