Evolution of the angular deformity and limb length discrepancy of congenital posteromedial bowing of the tibia over time
Ahmet Sevencan, Hanifi Ucpunar, Hakan Akgun, Osman Nuri Ozyalvac, Evren Akpinar, Avni Ilhan Bayhan, Timur Yildirim
Department of Orthopedics and Traumatology, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Türkiye
Keywords: Congenital anomalies, limb lengthening; limb length discrepancy, pediatric, posteromedial bowing, tibia.
Objectives: This study aims to assess the natural history of congenital posteromedial bowing of the tibia (CPMBT) deformity during growth and to evaluate the outcomes of lengthening by an Ilizarov frame in CPMBT patients with limb length discrepancy (LLD).
Patients and methods: Between January 2000 and December 2019, a total of 22 patients (12 males, 10 females; mean age: 10.5±4.4 years; range, 6 to 19 years) with the diagnosis of CPMBT and followed closely from birth until skeletal maturity were retrospectively analyzed. The radiographic evaluation included the anteroposterior and lateral interphyseal angle and full leg standing radiographs. Limb lengthening by an Ilizarov frame was performed for an estimated LLD over 40 mm.
Results: The age of the patients ranged from six days to 10 months at the time of presentation, while the mean age at the final followup was 10.5±4.4 years. Posterior medial bowing was satisfactorily remodeled in 13 (59%) patients those were not operated either for deformity or LLD. The mean LLD was 21±4.1 mm in 13 nonoperated CPMBT patients. Nine of 22 (41%) patients underwent lengthening for LLD. Five of the nine CPMBT patients were operated under the age of 10 years, while four were operated over the age of 10 years.
Conclusion: According to the results of the current study, CPMBT was satisfactorily remodeled in more than half of the patients, and the majority of patients did not undergo surgery for angular deformity and LLD within 10 years of their lives. Based on these findings, although most of the patientsʼ deformities remodeled, it should be kept in mind that some may require lengthening surgery.
Citation: Sevencan A, Ucpunar H, Akgun H, Ozyalvac ON, Akpinar E, Bayhan AI, et al. Evolution of the angular deformity and limb length discrepancy of congenital posteromedial bowing of the tibia over time. Jt Dis Relat Surg 2022;33(3):567-573.
The study protocol was approved by the Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital Ethics Committee (date/no: 14.04.2021/72/505). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Material preparation, data collection and analysis were performed: A.S., H.A., E.A., A.I.B., O.N.O. and T.Y.; The first draft of the manuscript was written by: A.S., and H.U.; All authors contributed to the study conception and design. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.