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Treatment of severe early onset Blount’s disease by an intra-articular and a metaphyseal osteotomy using the Taylor Spatial Frame

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Purpose

Severe Blount’s disease results in a multiplanar deformity of the lower limb. The mechanical axis is disrupted, there is a rotational deformity, and also shortening of the limb. A depression of the medial tibial plateau causes joint incongruity and instability. The purpose of this study is to review the results of treatment addressing all the aspects of the deformity.

Methods

Four patients were treated for severe Blount’s disease. The index procedure consisted of a medial tibial plateau elevating osteotomy, a lateral tibial and proximal fibular epiphysiodesis, a proximal tibial metaphyseal osteotomy, and the application of the Taylor Spatial Frame programmed for correction of varus, rotation and shortening, and preemptive lengthening to compensate for growth arrest.

Results

Mechanical axis was corrected from a mean 23° (13°–30°) to 0° in three patients and 6° valgus in 1. Tibias were lengthened by 1–4 cm. At follow-up, the mechanical axis was 0° in two patients and 7° varus in two. The overlengthening was diminishing as planned.

Conclusions

The double osteotomy and Taylor Frame correction was found to be accurate, safe, and effective for multiplanar deformity correction in severe Blount’s disease.

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Acknowledgments

No financial support was received for this study.

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Authors and Affiliations

  1. Pediatric Orthopedic Unit, Schneider Children’s Medical Center, 14 Kalpan St., 49202, Petah Tikva, Israel

    Elhanan Bar-On, Daniel Martin Weigl, Tali Becker & Kalman Katz

  2. Sackler Medical School, Tel Aviv University, Tel Aviv, Israel

    Elhanan Bar-On, Daniel Martin Weigl, Tali Becker & Kalman Katz

Authors
  1. Elhanan Bar-On
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  2. Daniel Martin Weigl
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  3. Tali Becker
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  4. Kalman Katz
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Corresponding author

Correspondence to Elhanan Bar-On.

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Bar-On, E., Weigl, D.M., Becker, T. et al. Treatment of severe early onset Blount’s disease by an intra-articular and a metaphyseal osteotomy using the Taylor Spatial Frame. J Child Orthop 2, 457–461 (2008). https://doi.org/10.1007/s11832-008-0140-y

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  • DOI: https://doi.org/10.1007/s11832-008-0140-y

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