Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

Objective:To assess the clinical and radiological results of acute surgical correction of severe adolescent Blount disease by single stage double level corrective osteotomy with elevation of the depressed medial tibial plateau using internal fixation. Background:Treatment of severe adolescent Blount disease is challenging. However, there is a consensus in the literature that early diagnosis and early aggressive surgical treatment are mandatory for a successful treatment and to prevent the progression of multiplanar deformity of the proximal tibia including varus, internal tibial rotation, procurvatum and the development of depression of the medial tibial plateau. Patients and method:The current prospective study included 20 patients (24 limbs) with a mean age of 13 years suffering from severe adolescent Blount disease treated by acute medial tibial plateau elevation, intra-epiphyseal, osteotomy together with another proximal tibial metaphyseal osteotomy to correct the rest of the deformity (remaining varus, internal tibial rotation and procurvatum) using internal fixation implant in the form of proximal tibial locked plate (4.5 mm LCP) applied medially with the aid of cannulated screws for plateau elevation. The follow-up time was from 6 to 18 months. Results: The mean pre-operative MTPDA was 31.6{u00B0}, the mean post-operative MTPDA was 4.95{u00B0}. The mean pre-operative FTA was 32.75{u00B0}of varus, the mean post-operative FTA was 2.75{u00B0} of valgus. The mean pre-operative FC-T angle was 60.5{u00B0}, the mean post-operative FC-T angle was 92.12{u00B0}. All of these changes in the radiographic parameters pre and post-operatively were statistically significant(p-value < 0.0001)

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