Natural history of infantile tibia vara

The Journal of Bone and Joint Surgery. British Volume
Y ShinoharaH Moriya

Abstract

We have observed the natural history without treatment of 46 limbs in 29 patients with infantile tibia vara and a metaphyseal-diaphyseal angle (MDA) of more than 11 degrees. The femorotibial angle (FTA) and MDA were measured, and Langenskiöld's classification of radiological changes in the proximal medial metaphysis of the tibia was used. In 22 limbs which were not in Langenskiöld stages II to III the condition resolved spontaneously without treatment. Of the remaining 24 which were in stages II to III, in 18 it resolved spontaneously by the age of six years, but six showed little or no improvement at the latest follow-up. It was impossible to differentiate by measuring the FTA or MDA whether spontaneous resolution could be expected before the age of four years. There was no difference in the rate of resolution of the deformity between those patients who had been treated by a brace and those who had received no treatment. We advise no initial treatment but review at six-monthly intervals until the age of four years, even in patients with Langenskiöld stage-II to stage-III deformity. When a deformity persisted or progressed we carried out a corrective osteotomy after the age of four years.

Citations

Jul 9, 2010·Orthopaedics & Traumatology, Surgery & Research : OTSR·J-M LavilleF Salmeron
Jun 3, 2016·Nigerian Journal of Clinical Practice·F HollmanH M Staal
Jul 3, 2009·The Journal of Bone and Joint Surgery. American Volume·Sanjeev Sabharwal
Feb 25, 2017·Journal of Pediatric Orthopedics·Lauren E LaMontCharles E Johnston
Aug 12, 2017·Journal of Pediatric Orthopedics·Samir Sabharwal, Sanjeev Sabharwal

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