McCarthy James J, MacIntyre Neil R, Hooks Brian, Davidson Richard S
Shriners Hospitals for Children, Philadelphia, PA, USA.
J Pediatr Orthop. 2009 Mar;29(2):115-9. doi: 10.1097/BPO.0b013e3181982512.
Treatment for severe/relapsing Blount disease is controversial. The purpose of this study is to assess the safety and efficacy of acute medial plateau elevation with concurrent tibial gradual osteotomy.
This study is a retrospective review of 16 patients (22 limbs) treated by combined plateau elevation and tibial osteotomy for the treatment of Blount disease. We measured the tibiofemoral angle, medial proximal tibial angle, and the plateau angle.
All measurements improved significantly preoperatively to postoperatively. The tibiofemoral angle from 29 degrees varus to 3 degrees of valgus, anatomic medial proximal tibial angle from 55 degrees to 86 degrees, and the plateau angle from 37 degrees to 12 degrees (P<0.05). Five patients were considered to have failed which appeared to be the result of undercorrection and subsequent recurrence of the tibial osteotomy and not the plateau elevation.
The double osteotomy for Blount disease achieved significant improvement in all patients recurrence appeared to be because of under correction and subsequent worsening of the tibial osteotomy and not collapse of the plateau elevation.
IV.
重度/复发性布朗特病的治疗存在争议。本研究的目的是评估急性内侧平台抬高联合胫骨渐进性截骨术的安全性和有效性。
本研究是一项对16例患者（22条肢体）进行的回顾性研究，这些患者接受了联合平台抬高和胫骨截骨术治疗布朗特病。我们测量了胫股角、胫骨近端内侧角和平台角。
所有测量值术前到术后均有显著改善。胫股角从内翻29度变为外翻3度，解剖学胫骨近端内侧角从55度变为86度，平台角从37度变为12度（P<0.05）。5例患者被认为治疗失败，这似乎是胫骨截骨矫正不足及随后复发的结果，而非平台抬高的问题。
布朗特病的双截骨术使所有患者均有显著改善，复发似乎是由于矫正不足及随后胫骨截骨情况恶化，而非平台抬高塌陷。
IV级。
