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Treatment of severe early-onset Blount’s disease by simultaneous medial hemiplateau elevation and metaphyseal osteotomy using the Ilizarov fixator
Faculty
Medicine
Year:
2018
Type of Publication:
ZU Hosted
Pages:
Authors:
Ahmed Mohamed Abdelwahab Elsayed Elemem
Staff Zu Site
Abstract In Staff Site
Journal:
International Journal of Orthopaedics Sciences www.orthopaper.com
Volume:
Keywords :
Treatment , severe early-onset Blount’s disease , simultaneous
Abstract:
Abstract The purpose of this study was to evaluate the outcome of simultaneous medial tibial plateau (MTP) elevation and metaphyseal osteotomy using Ilizarov fixator in severe early-onset Blount’s disease. Patients and methods: Between 2012 and 2017, we treated 10 cases (14 limbs) of severe early-onset Blount’s disease by double tibial osteotomy procedure using Ilizarov fixator. Their mean age was 10.3 years (9 – 13). All were Langenskiold's stages V /VI with MTP-depression > 30°. Results: The mean follow-up period was 18 months (12 - 32 months). Radiographically; (a) The tibio-femoral angle (TFA) changed from -35° (-25 to -49°), preoperatively to +3.1° (-1 to +9°), postoperatively (P=0.00), and to 0.9 (-5° to + 3°) finally (P=0.06). (b) The medial proximal tibial angle (MPTA) changed from 52° (44 – 63°) preoperatively, to 90° (90 to 95°) postoperatively (P=0.00), and to 87°.8 (83 – 90°) finally (P=0.23). (c) The medial tidial plateau depression angle (MTPDA) changed from 38°(32 – 57) preoperatively, to 6° (0 -8) postoperatively (P=0.00), and to 7° (2 -9°) finally (P=0.21). (d) The mechanical lateral distal femoral angle (mLDFA) was 86°(83 – 88°) and showed no significant change till finally. The outcome according to Schoenecker’s criteria was good in 12 limbs and medium in two. Complications included pin tract infection (10 limbs), temporary foot drop (one limb), and distal osteotomy delayed union (two tibias). Conclusions: This procedure is reliable in treating severe early-onset Blount disease, in terms of joint congruence, limb axes and limb length discrepancy. Keywords: Blount disease, double osteotomy, plateau elevation, tibial osteotomy
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Ahmed Mohamed Abdelwahab Elsayed Elemem, "The triangle tilt procedure for treatment of secondary shoulder deformities in obstetric brachial plexus injury", www.orthopaper.com, 2018
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Ahmed Mohamed Abdelwahab Elsayed Elemem, "Management of Blount s disease by external fixator", Zagazig University, 2015
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Ahmed Mohamed Abdelwahab Elsayed Elemem, "V-Shaped Corrective Ulnar Osteotomy in Neglected Monteggia Fracture Dislocation in Children", OMICS, 2017
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Ahmed Mohamed Abdelwahab Elsayed Elemem, "Mini-anterior approach for surgical reduction of developmental dysplasia of the hip: a case series", Wolters Kluwer Health, 2021
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Department Related Publications
Alaa Ahmed Musstafa, "• Transpedicular Stabilization of Thoracolumbar Spinal Fractures.", لايوجد, 1900
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Mohamed Anwar Abdel Haleem, "كسور النهاية البعيدة لعظمة الفخد مقارنة بين العلاج الجراحى والعلاج التحفظي", لايوجد, 1900
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