Modified dome shaped proximal tibial osteotomy for treatment of infantile tibia vara
Background: Tibial deformity in childhood is not always one plane deformity, but often combines torsional and angular malalignment. Methods: In this prospective study, dome shaped osteotomy was performed in 36 tibiae in 24 patients. The osteotomy was held with K wires and a plaster cast. The mean age at surgery was 5.5 years and the mean follow up time was 30 months, range (24 42) months. Results: All osteotomies united and no compartment syndrome occurred. Postoperatively, one leg (2.7% had temporary weakness of external hallucis longus muscle. Thirty five of thirty six legs had good clinical and radiological correction of alignment. Recurrent deformity was seen in one leg. Conclusions: Dome shaped osteotomy of the tibia is a simple, safe and effective method for correction of uni planar varus deformity. For bi planar deformities in childhood with infantile tibia vara we may need to step cut the lateral cortex to allow good bone contact to help in union with minimum morbidity.