Purpose
The purpose of this study was to evaluate the results of combined high tibial AQ7
osteotomy in combination with gradual translation by ilizarov external fixator in the
treatment of late-onset tibia vara.
Patients and methods
A total of 23 patients with a diagnosis of late-onset tibia vara, 16 (69.6%) male and
seven (30.4%) female, were included in this study; in 14 (60.9%) patients the
deformity was on the right side, whereas in nine (39.1%) patients the deformity was
on the left side.
The etiology was Blount’s disease in all patients. The mean age of the patients was AQ8
23 years, ranging from 13 to 35 years, and the mean preoperative mechanical axis
deviation was 84.39 mm. The mean preoperative medial posterior tibial angle was
61.17°, whereas the mean preoperative proximal posterior tibial angle was 63.09°.
Results
The mean duration of external fixator application was 124.6 days, ranging from 90
to 170 days; the mean postoperative medial proximal tibial angle was 86.22°, with a
P value of 0.001; the mean postoperative proximal posterior tibial angle was 79.74°,
with a P value of 0.001; and the mean postoperative mechanical axis deviation was
10.7 mm, with a P value of 0.001.
Residual deformity was present in three (13%) cases, ranging from 5 to 18°; no
neurovascular complication was seen in both early and late postoperative periods;
and limb length discrepancy was present in five (21.7%) cases, which was between
1.5 and 2.7 cm.
Conclusion
High tibial osteotomy in combination with gradual correction by ilizarov is safe and
effective in the management of late-onset tibia vara.