Low profile ilizarov frame in correction of varus deformity in patients with adolescent blount's disease

Background: Adolescent Blount disease or late onset tibia vara constitutes the most common cause of pathologic genu varum in late childhood and adolescence. It is a developmental condition characterized by disordered endochondral ossification of the posteromedial part of the proximal tibial physis resulting in multiplanar deformities of the lower limb

Objective: the aim of this work was to evaluate the results of treatment of acute correction of varus deformity in patients with Blount disease by using low profile Ilizarov frame

Patients and Methods: It is a retrospective and a prospective study for 10 patients who had adolescent Blount disease treated by acute correction using low profile Ilizarov frame. We looked principally into the following variables to evaluate the results of the treatment: Deformity correction [expressed as mechanical axis restoration], the average normal values were used as a reference [medial proximal tibial angle, 85-90; posterior proximal tibial angle, 77-84; thigh-foot angle, +10 external rotation]

Results: the patients were 9 boys [90%] and one girl [10%]. The mean age at presentation was 13.60 years, range [ 11- 17 years] , 6 patients [60%] presented with unilateral affections and 4 patients [40%] presented with bilateral affection. Mean preoperative to postoperative changes of MPTA from 74.57 [range 65-80] improved to 89.21 [range 86-95], Mean preoperative to postoperative changes of PPTA from 74.21 [range 66-80] improved to 79.07 [range 77-82] , Mean preoperative to postoperative changes of MAD from 31.14 mm [range 18-45 mm] improved to 3.64 mm [range 0-8 mm]. Mean preoperative to postoperative changes of TFA from -23.57 [range -30 -15] of internal tibial torsion improved to 5.36 [range 0-10] of external tibial torsion

Conclusion: Management of adolescent Blount disease by acute correction strategy using a low profile Ilizarov is a safe technique offering excellent results with low incidence of complications. Low profile Ilizarov is lighter and less bulky so more comfortable for patients than classic Ilizarov external fixation , Acute correction technique can achieve the same result of correction as gradual correction technique in patient with no limb length discrepancy , Acute correction offers a shorter time in frame as compared to gradual correction with fewer follow-up visits and exposure to radiation

Angular deformities of the lower limb in children

Angular deformities of the lower limbs are common during childhood. In most cases this represents a variation in the normal growth pattern and is an entirely benign condition. Presence of symmetrical deformities and absence of symptoms, joint stiffness, systemic disorders or syndromes indicates a benign condition with excellent long-term outcome. In contrast, deformities which are asymmetrical and associated with pain, joint stiffness, systemic disorders or syndromes may indicate a serious underlying cause and require treatment. Little is known about the relationship between sport participation and body adaptations during growth. Intense soccer participation increases the degree of genu varum in males from the age of 16. Since, according to some investigation, genu varum predisposes individuals to more injuries, efforts to reduce the development of genu varum in soccer players are warranted. In this article major topics of angular deformities of the knees in pediatric population are particularly reviewed