Modified Oblique High Tibial Osteotomy with Minimal Fixation for Correction of Adolescent Tibia Vara

Abstract

Tibia vara was described by Blount in 1937. The 6 radiographic stages classification proposed by Langenskiöld and Riska in 1964 represents the progression of the disease if left untreated. The etiology of tibia vara remains unknown; however, it was proposed that growth arrest of the posteromedial aspect of the proximal tibial physis is due to increased compressive forces on the medial side with tensile forces applied on the lateral aspect. Early aggressive treatment of tibia vara is recommended before development of complex deformities of the proximal tibia with depression of the tibial plateau. The earlier the management and stage of disease, the less likely the incidence of recurrence. The management of early stages consists mainly of a metaphyseal valgus osteotomy with a slight over-correction to alter the compressive forces on the medial physis to tensile forces. However, advanced stages of the disease represent a more challenging case, due to high rates of recurrence and possibly the permanent damage to the medial physis. Left untreated, or treated by a simple metaphyseal osteotomy, the