Author(s)

Alfred O. Ogbemudia^1*, Anirejuoritse Bafor¹, Ehimwenma J. Ogbemudia², Edwin Edomwonyi³

¹Department of Orthopaedics and Trauma, University of Benin Teaching Hospital, Benin City, Nigeria.
²Department of Medicine, University of Benin, Benin City, Nigeria.
³Department of Orthopaedics and Trauma, Irrua Specialist Teaching Hospital, Irrua, Nigeria.

Background: Blount disease is frequently associated with deformities that may not be adequately corrected by a single metaphyseal osteotomy. This study evaluated the outcome of a combined metaphyseal and epiphyseal osteotomy in severe cases. Methods: We prospectively evaluated the outcome of combining the antero-posterior inverted-U metaphyseal osteotomy with a medial open-wedge hemi-epiphyseal osteotomy in eighteen patients (27 tibiae) with Stage IV to VI Blount disease. Results: The average age of patients was 9 years (ranging from 5 to 17). The tibio-femoral angle improved from 43° varus (Range: 34° - 78°) to 2° varus (Range: 5° valgus to 8° varus). The metaphyseal-diaphyseal angle improved from 36° to 8° varus. Internal tibial torsion improved from 39° to 2°. All the patients were able to achieve 110° of knee flexion in a year. Conclusion: In conclusion, the combined metaphyseal and epiphyseal osteotomy satisfactorily corrected tibio-femoral and metaphyseal-diaphyseal varus and internal tibial torsion without recurrence in patients with severe Blount disease. Level of Evidence: IV.

Blount Disease, Double Osteotomy, Tibial Osteotomy, Blount Disease

Ogbemudia, A. , Bafor, A. , Ogbemudia, E. and Edomwonyi, E. (2015) Combined Antero-Posterior Inverted-U Metaphyseal and Open-Wedge Medial-Epiphyseal Osteotomy for Advanced Blount Disease. Surgical Science, 6, 162-169. doi: 10.4236/ss.2015.64026.