High tibial osteotomy in the treatment of infantile Blount's disease.

The results after high tibial osteotomy (proximal to the tibial tubercle) in 23 tibiae (17 children) with infantile Blount's disease are described. The average age at the time of surgery was 5.3 years and the average follow up 4.5 years. The surgical result was good in the tibiae with Grade A deformity. In cases with Grade B deformity a good result was obtained in 4 tibiae and there was a recurrence of the deformity in 1 case. In Grade C the result was good in 3 tibiae, fair in 1, poor in 3 and there was a recurrence of the deformity in I. In Grade D the result was good in 1 tibia, fair in 1 and there was a recurrence of the deformity in 2 cases. Overall, the less severe the degree of the deformity, the better the postoperative surgical outcome. The authors prefer the high tibial osteotomy because it provides a better correction of the varus deformity, better fixation because of the stabilizing role of the patellar ligament, and the union of the osteotomy is easier due to the cancellous bony structure in the metaphysis.