Modified Dome Shaped Proximal Tibial Osteotomy in Management of Blount Disease

Abstract

Background: Blount's disease is commonly attributed to an intrinsic, idiopathic defect in the posteromedial proximal tibial physis resulting in progressive bowing of the leg, intoeing, and lateral knee thrust. Treatment has historically included bracing, physeal stapling, or corrective osteotomy, and was determined primarily by age at presentation.

Method: ten patients (twelve limbs) with early onset Blount's disease (infantile tibia vara) were managed between January 2015 and December 2018 by modified dome shaped osteotomy with adding cut at lateral cortex is done to twelve limb. This osteotomy is fixed by 2 k.wires and casting. The average age of children was 4.25 years and follow up time was 12 months.

Results: revision of correction and fixation done to two limb in early stage and five case after casting enter to physiotherapy program against stiffness otherwise there is no permanent complication or problem need to manage

Conclusion: Correction of Blount disease by modified dome shaped osteotomy is effective intervention in infantile type (during childhood). We added cut of lateral cortex after osteotomy to give good bone contact to correct the internal torsion. The short-term outcomes are good and promising with low complication rates and good consolidation. Long-term follow-up results of these patients are needed to observe possible long term complications.