Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Paediatrics
Abstract number: 25692
SURGICAL TREATMENT OF BLOUNT DISEASE IN CHILDREN
Mikhail GERASIMENKO 1 , Alexandr BELETSKY 2 , Mikhail KOREN 3 , Eugene ZHUK 1
1 Belarusian State Medical University, Minsk (BELARUS), 2 Republican Scientific-
Practical Centre of Traumatology and Orthopaedics, Minsk (BELARUS), 3 City Clinical
Center of Traumatology and Orthopaedics, Minsk (BELARUS)
Blount disease (BD) is characterized by abnormalities occurring in the medial part of
the proximal tibial metaphysis, physis, and epiphysis, and declares by genu varum
(more 20 degr. during the weightbearing), lateroposition of shin and «thrust» during
stance phase of gait, often at obese patients. The main method of operative
treatment of BD in Belarus is osteotomy, at this moment transverse auto-plastical OT
of shin bones with moderate overcorrection (5-10 degrees) of deformation. During
the period from 1987 to 2004 year 51 operations at 45 knees (21 right, 24 left) of 37
patients with BD at age 2-17 years old (9 boys, 28 girls) were performed. All patients
had clinical picture of legs bowing (from 20 to 55 degrees), lateral instability 5-20
degrees, in 26 cases - internal torsion of tibia from 10 to 45 degrees and secondary
pes planus. Treatment: 49 osteotomies were performed, 10 of them (20,4%) of tibia
alone, other of tibia and fibula, in 6 cases also epiphysiodesis was made; in 2 cases
of recurrence BD isolated epiphysiodesis was performed. Methods of osteotomies:
wedge - 27 (55,1 %), spherical - 4 (8,2 %), triangular - 4 (8,2 %), transverse autoplastical
- 14 (28,6 %). Fixation was performed with help of Kirschner's wires (44
cases) or Ilizarov’s device (5 cases). Long-term (from 1 to 21 years, average - 9,4
years) postoperative results were available for 33 patients: good at 14 patients (42,4
%), satisfactory at 13 patients (39,4 %), poor at 6 patients (18,2 %) required another
osteotomies.
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