Outcome of Dome-Shaped Proximal Tibial Osteotomy in Infantile Genu Varum

Abstract

Background: The goals of the proximal tibial osteotomy are correcting the deformity, Hip-knee-ankle angle, and preventing the progress of the destruction of the medial compartment of the knee joint.
Objectives: The aim of the work was to evaluate the outcome of children with genu varum after proximal tibial dome shaped osteotomy.
Patients and Methods: These randomized clinical trials study included a total of 10 patients with 12 affected knees confirmed with persistent physiologic genu varum, attending at Orthopedic Department, Zagazig University Hospitals, Zagazig, Egypt. All cases were evaluated pre and post-operatively according to Modified Hospital for Special Surgery Knee Scoring System (HSSKS) as shown in appendix I. cases were assessed for functional improvement after surgery at 2, 4 months and detection of malunion or delayed union after 3 months.
Results: The mean (±SD) pre-operative tibio-femoral angle was 21.7 (±5.6) versus 3.18 (±1.97) post-operatively, preoperative femoral condyle-tibial shaft angle (FTA) was 16.3 (± 2.8) versus 3.2 (±1.1) post-operatively and preoperative metaphyseal diaphyseal angle was 15.8 (±2.6) versus 3.6 (±1.2) post-operatively with a statistically significant difference in between (p < 0.05). The mean pre-operative HSSKS scores were 70.16±11.3 while the mean post-operative HSSKS scores were 91.4±2.1.
Conclusion: It could be concluded that proximal tibial osteotomy using dome-shaped procedure to correct Infantile Genu varum deformity, has favorable treatment outcomes, does not involve any dangerous complications, and can be used as a safe and effective treatment method for the correction of infantile genu varum deformity. In the current study, angles significantly improved, most of legs got full correction and little complications occurred.