Abdelgawad Amr A
Amr A Abdelgawad, Department of Orthopedic Surgery, Texas Tech University Health Science Center at El Paso, El Paso, TX 79905, United States.
World J Orthop. 2013 Apr 18;4(2):90-3. doi: 10.5312/wjo.v4.i2.90.
Infantile Blount's disease is a condition that causes genu varum and internal tibial torsion. Treatment options include observation, orthotics, corrective osteotomy, elevation of the medial tibial plateau, resection of a physeal bar, lateral hemi-epiphysiodesis, and guided growth of the proximal tibial physis. Each of these treatment options has its disadvantages. Treating the coronal deformity alone (genu varum) will result in persistence of the internal tibial torsion (the axial deformity). In this report, we describe the combination of lateral growth modulation and distal tibial external rotation osteotomy to correct all the elements of the disease. This has not been described before for treatment of Blount's disease. Both coronal and axial deformities were corrected in this patient. We propose this combination (rather than the lateral growth modulation alone) as the method of treatment for early stages of Blount's disease as it corrects both elements of the disease and in the same time avoids the complications of proximal tibial osteotomy.
婴儿型布朗特病是一种导致膝内翻和胫骨内旋的病症。治疗选择包括观察、矫形器、矫正截骨术、胫骨内侧平台抬高、骨桥切除术、外侧半骨骺阻滞术以及胫骨近端骨骺引导生长。这些治疗选择中的每一种都有其缺点。仅治疗冠状面畸形（膝内翻）会导致胫骨内旋（轴向畸形）持续存在。在本报告中，我们描述了外侧生长调节与胫骨远端外旋截骨术相结合以纠正该疾病的所有要素。此前尚未有关于这种方法治疗布朗特病的描述。该患者的冠状面和轴向畸形均得到了纠正。我们建议将这种联合治疗方法（而非仅外侧生长调节）作为布朗特病早期阶段的治疗方法，因为它能纠正疾病的两个要素，同时避免胫骨近端截骨术的并发症。
