Diastases of the proximal tibial physis in tibia vara

Previous histopathologic Studies of the proximal tibial physis in tibia vara have shown changes similar to those seen in slipped capital femoral epiphysis. The present paper describes radiographic widening of almost the entire upper tibial physeal plate in 6 knees with adolescent tibia vara, and opening of the lateral part of the proximal tibial physis in 4 knees with juvenile Blount's disease. These appearances, which suggest a diastasis of the physis, resolved after corrective tibial osteotomy. Forces acting across the proximal tibial physis are discussed. We postulate that the physical properties of the proximal tibial epiphysis and its response to mechanical forces acting upon it are age related. These factors determine the radiographic differences between juvenile and adolescent tibia vara

Physical remodeling of valgus slipped capital femoral epiphyses

Valgus displacement of the capital femoral epiphysis occurs very rarely. Physeal remodelling, not previously reported in valgus slips, is herein described in three hips. It provides further support for the concept of initial pin fixation and observing for any remodelling to occur that may obviate the need for femoral neck osteotomies