engleski

Results after surgical treatment with 3-D external fixator in children with Blount's disease

Purpose. The goal of this study is to evaluate the effectiveness of the AO 3-D external fixateur (EF) in proximal tibial valgus osteotomy. Significance. Possibility for improvement of the surgical outcome in children with Blount's disease. Summary of method, results and discussion. Hospital charts in the period from 1976. to 1996. were reviewed. Twenty-one patient treated with valgus osteotomy were found, and three patients were lost for follow-up or had insufficient data. Seventeen girls and one boy (20 operated limbs) were the basis for retrospective clinical and radiographic analysis. Follow-up was 9, 5 years on average (range: 2 to 20 years). Thirteen patients were skeletaly mature at follow-up. Fourteen limbs were fixed with EF, and six limbs with plate, staples or plaster of paris respectivelly. Duration of FE varied, with less time in younger patients (average 12 weeks) and longer time (16 to 36 weeks) in late-onset disease. All operated tibias in EF group healed with unions. At follow-up twelve patients (14 limbs) were asymptomatic. Femoro-tibial angle and proximal methaphyseal-diaphyseal angle were used for radiographic evaluation. Excellent result was defined as a value within reported normal range of 5 degrees of varus to 2 degrees of valgus. According to this criteria all limbs except one in the EF group were excellent. On the contrary, in non-EF group (six limbs) was one excellent result, only. There were three patients with complications in each group. Four patients (one in EF group) had recurrences, one patient had deep pin tract infection and one 3, 5 cm. of limb shortening. Conclusion. In our experience, despite of some limitations especially in 3 to 4 years old patients, EF showed superior mid-term results over other means of the proximal tibial fixation devices.

Blount's disease ; external fixation ; 3-dimensional ; results

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