Valgus Rotational Dome Osteotomy for Neglected Adult Blount's Disease: A Surgical Case Report.

Blount's disease (BD) is a progressive lower extremity deformity resulting from impaired growth of the proximal medial tibial physis, commonly leading to tibia vara. While early cases may benefit from conservative management, surgical correction is often required in neglected or severe presentations, particularly in adults. We report the case of an adult female with an eight-year history of medial-sided knee pain secondary to medial compartment varus overload as a result of tibia vara due to neglected BD. Following significant weight loss, the patient underwent a valgus-producing rotational dome tibial osteotomy with plate fixation of the medial tibial plateau, achieving 15 degrees of angular correction in a single procedure. Given the high bone contact of both sides of the osteotomy, the patient had a fast and successful recovery. At the final follow-up, six years after the procedure, the patient demonstrated proper limb alignment, resolution of pain, and return to daily physical activities without complications. This case highlights the viability of this surgical technique as a potential option for managing severe tibia vara deformities in adult patients with neglected BD.