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外翻旋转穹窿截骨术治疗成人陈旧性布朗特病:1例手术病例报告

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

作者信息

Rivera Troia Felix, Perez Lopez Carlos J

机构信息

Orthopedic Surgery, Ponce Health Sciences University, Ponce, PRI.

出版信息

Cureus. 2025 May 25;17(5):e84764. doi: 10.7759/cureus.84764. eCollection 2025 May.

Abstract

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.

摘要

布朗特病(BD)是一种由于胫骨近端内侧骨骺生长受损导致的进行性下肢畸形,通常会导致膝内翻。虽然早期病例可能受益于保守治疗,但在被忽视或严重的情况下,尤其是在成人中,通常需要手术矫正。我们报告了一例成年女性病例,该患者因被忽视的布朗特病导致膝内翻,内侧间室负荷过重,继发内侧膝关节疼痛长达八年。在显著减重后,患者接受了外翻旋转穹顶胫骨截骨术,并使用钢板固定胫骨内侧平台,单次手术实现了15度的角度矫正。鉴于截骨两侧的骨接触良好,患者恢复迅速且顺利。在术后六年的最后随访中,患者肢体对线良好,疼痛消失,能够恢复日常体力活动且无并发症。该病例突出了这种手术技术作为治疗被忽视的布朗特病成年患者严重膝内翻畸形的潜在选择的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f73a/12187042/a302194d3b1a/cureus-0017-00000084764-i01.jpg

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