Late-onset
tibia vara or Blount's disease is the most common cause of pathologic
genu varum in children and adolescents. Treatment remains controversial. Many studies in the past have shown that an
osteotomy with acute correction is the most appropriate treatment. More recently however, there has been a growing interest, especially in severe cases, in using gradual correction with the
Ilizarov technique after a single high tibial
osteotomy. A retrospective study in 20 children with late-onset
tibia vara, who were treated by gradual angulation translation high tibial
osteotomy using the
Ilizarov technique, was performed. The mean follow-up period was 2.9 years (range: 2-4 years; SD 0.75). Recurrence of varus
deformity to various degrees was noted in 10 of 22 cases (45.5%). Recurrence of
deformity was found to be significantly related to both the degree of pre-operative deviation and the duration of follow-up. No statistically significant relationship was found between recurrence and the age of the patients at the time of the operation. Angulation translation high tibial
osteotomy using the
Ilizarov technique is a unique method for realignment of the mechanical axis in late onset
tibia vara. It also allows for correction of associated
deformities. The rate of recurrence of varus
deformity is however relatively high.