Wright, J;
Hill, RA;
Eastwood, DM;
Hashemi-Nejad, A;
Calder, P;
Tennant, S;
(2018)
Posteromedial bowing of the tibia: A benign condition or a case for limb reconstruction?
Journal of Children's Orthopaedics
, 12
(2)
pp. 187-196.
10.1302/1863-2548.12.170211.
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Abstract
PURPOSE: To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. PATIENTS AND METHODS: In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures. RESULTS: The greatest correction of deformity occurred in the first year of life, but after the age of four years, remodelling was limited. The absolute leg-length discrepancy (LLD) increased throughout growth with a mean 14.3% discrepancy in tibial length. In the lengthening group, mean length gained per episode was 45 mm (35 to 60). Mean duration in frame was 192 days, with a mean healing index of 42.4 days/cm. Significantly higher rates of recurrence in LLD were seen in those undergoing lengthening under the age of ten years (p = 0.046). Four contralateral epiphysiodeses were also performed. CONCLUSION: Posteromedial bowing of the tibia improves spontaneously during the first years of life, but in 20/38 (53%) patients, limb reconstruction was indicated for significant residual deformity and/or worsening LLD. For larger discrepancies and persistent deformity, limb reconstruction with a hexapod external fixator should be considered as part of the treatment options. Level of evidence Level IV (Case series).
| Type: | Article |
|---|---|
| Title: | Posteromedial bowing of the tibia: A benign condition or a case for limb reconstruction? |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1302/1863-2548.12.170211 |
| Publisher version: | http://dx.doi.org/10.1302/1863-2548.12.170211 |
| Language: | English |
| Additional information: | © 2018, British Editorial Society of Bone and Joint Surgery. This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
| Keywords: | Posteromedial bowing; tibia; limb reconstruction; tibial recurvatum |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10059595 |
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