Abstract: Introduction: Blount disease is a growth affection characterized by disordered endochondral ossiï¬cation of the medial part of the proximal tibial physis resulting in multiplanar deformities of the lower limb. Their management is complex and must consider the deformations associated in all the plans. Several therapeutic options can be used. We report a series of 31 patients treated by osteotomy in single step operative procedure.
Patients and Methods: It was a retrospective study relating a series continues prospective of 39 knees (31 patients) treated in three different centers in the same period between January 2012 and September 2020. All the patients had an advanced genu varum in the setting of Blount’s disease. All the patients had a preoperative pangonometry. The procedure began with a closing-wedge distal femoral osteotomy fixed by plate, when the femoral valgus was associated. The operative procedure comprised four stages. a fibular osteotomy, double tibial osteotomy, osteotomy of the medial tibial plateau and hemiepiphysiodesis of the lateral proximal tibial epiphysis. All the patients were followed clinically and by radiographs in 45th, 60th and 180th day. The clinical assessment and functional calculus were based on the criteria of Schoenecker.
Results: At the last 7.4 months follow-up (3 - 13), no complications were observed. Bone consolidation was acquired in 100% of cases. The Schoenecker score was considered good in 10/23 patients (43.47%) and average in 12/23 patients (52.21%). In three (3) patients, the results were considered poor. Two (2) of them were repeated for better restoration of the joint space and the last one was lost to follow-up
Conclusion: Blount disease is rare but can be severe. Double ostetomy of medial tibial plateau remains a therapeutic option in the context of developing countries.
