Do we need to do overcorrection in Blount's disease?

被引:20
作者
Eamsobhana, Perajit [1 ]
Kaewpornsawan, Kamolporn [1 ]
Yusuwan, Kittipong [1 ]
机构
[1] Mahidol Univ, Siriraj Hosp, Fac Med, Dept Orthoped Surg, Bangkok 10700, Thailand
关键词
Blount's disease; Corrective valgus osteotomy; Recurrence; Langenskiold; INFANTILE TIBIA VARA; BRACE TREATMENT; OSTEOTOMY;
D O I
10.1007/s00264-014-2365-3
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose In order to prevent recurrent deformity, overcorrection in Blount's disease has been a common practice by most paediatric orthopaedic surgeons. However, some patients have persistent valgus alignment resulting in awkward deformity. The femoro-tibial angle (FTA) was measured in this series of cases to determine the necessity of such practice. Method During 1998-2010, patients with Blount's disease stage 2 by Langenskiold, aged from 30 to 40 months who had failed from bracing and underwent valgus osteotomy were included. Seventeen legs had postoperative FTA 7-13 degrees (group 1) and 48 legs had postoperative FTA more than 13 degrees (group 2). ROC curve was used to determine the appropriate FTA that was suitable to prevent recurrence. Results Four legs had recurrence (28.6 %) in group 1 and six legs (12.5 %) had recurrence in group 2. Chi-square test between two groups were not statistically significant in recurrence (p = 0.434). Age and BMI were not statistically significant between recurrent and non-recurrent groups. The ROC curve shows that overcorrection more than 15 degrees did not show benefit to prevent the recurrence in Blount's stage 2. Conclusion Our study showed that the overcorrection group had non-statistically significant recurrence compared to the non-overcorrection group, and overcorrection more than valgus 15 degrees has no benefit to prevent recurrence.
引用
收藏
页码:1661 / 1664
页数:4
相关论文
共 18 条
[1]  
BATHFIELD CA, 1978, CLIN ORTHOP RELAT R, P29
[2]  
Blount W P, 1966, Curr Pract Orthop Surg, V3, P141
[3]  
Bs D, 1996, J PEDIATR ORTHOPED, V16, P469
[4]   Recurrence of varus deformity after proximal tibial osteotomy in Blount disease: Long-term follow-up [J].
Chotigavanichaya, C ;
Salinas, G ;
Green, T ;
Moseley, CF ;
Otsuka, NY .
JOURNAL OF PEDIATRIC ORTHOPAEDICS, 2002, 22 (05) :638-641
[5]   INFANTILE TIBIA VARA - FACTORS AFFECTING OUTCOME FOLLOWING PROXIMAL TIBIAL OSTEOTOMY [J].
FERRITER, P ;
SHAPIRO, F .
JOURNAL OF PEDIATRIC ORTHOPAEDICS, 1987, 7 (01) :1-7
[6]  
Gonzàlez-Herranz P, 2005, J PEDIATR ORTHOPED, V25, P130, DOI 10.1097/00004694-200501000-00028
[7]   INFANTILE TIBIA VARA [J].
GREENE, WB .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1993, 75A (01) :130-143
[8]   Serrated W/M osteotomy - Results using a new technique for the correction of infantile tibia vara [J].
Hayek, S ;
Segev, E ;
Ezra, E ;
Lokiec, F ;
Wientroub, S .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2000, 82B (07) :1026-1029
[9]   BLOUNTS DISEASE AFTER SKELETAL MATURITY [J].
HOFMANN, A ;
JONES, RE ;
HERRING, JA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1982, 64 (07) :1004-1009
[10]   Outcome Analysis of Surgery for Blount Disease [J].
Jones, Jerome K. ;
Gill, Laura ;
John, Mario ;
Goddard, Maria ;
Hambleton, Ian R. .
JOURNAL OF PEDIATRIC ORTHOPAEDICS, 2009, 29 (07) :730-735