UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Posteromedial bowing of the tibia: A benign condition or a case for limb reconstruction?

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. Green open access

[thumbnail of Wright_1863-2548.12.170211.pdf]
Preview
Text
Wright_1863-2548.12.170211.pdf - Published Version

Download (11MB) | Preview

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
Downloads since deposit
97Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item