Gradual on top-of-acute correction of neglected adolescent tibia vara by percutaneous tibial osteotomy and two-ring Ilizarov frame

Abstract

Objectives: This study aims to assess the effect of gradual correction after acute translation of the tibia in tibia vara using a two-ring Ilizarov frame on the correction of mechanical axis deviation (MAD), union time, and the rate of complications.

Patients and methods: Between September 2018 and January 2021, a total of 30 patients (25 males, 5 females; mean age: 20±5 years; range, 15 to 25 years) with adolescent tibia vara were included. The patients had a transverse fibular ostectomy and percutaneous tibial osteotomy below the level of the tibial tuberosity. Acute correction of the rotation deformity combined with acute translation was done. A tworing Ilizarov frame with a medial distractor and two lateral hinges were used to fix the osteotomy and the coronal plane deformity was gradually corrected.

Results: The mean follow-up was 24±4 months. All patients had improvement in the mechanical medial proximal tibial angle (mMPTA) and MAD postoperatively. There was an improvement in the Hospital for Special Surgery knee score at one year postoperatively. No neurovascular complications or union complications were observed.

Conclusion: Acute translation followed by gradual angulation of the proximal tibia in cases with adolescent tibia vara yields better correction of the mechanical axis with good functional and radiological outcomes.

Citation: Kholeif AM, Mohamed ABZ, Bashandy AS, Khedr AM. Gradual on top-of-acute correction of neglected adolescent tibia vara by percutaneous tibial osteotomy and two-ring Ilizarov frame. Jt Dis Relat Surg 2023;34(2):265-270. doi: 10.52312/jdrs.2023.1072.

The study protocol was approved by the Cairo University Ethics Committee (date: 27.07.2020, no: MD-213-2020). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Idea/concept: A.S.B., A.M.K., A.B.Z.M.; Design, analysis and/or interpretation, writing the article: A.M.K., A.S.B.; Control/supervision: A.M.K., A.B.Z.M.; Data collection and/or processing, literature review, references and fundings, materials: A.S.B.; Critical review: A.B.Z.M.

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.

A written informed consent was obtained from each patient and/or parents or legal guardians of the patient.

The data that support the findings of this study are available from the corresponding author upon reasonable request.