BACKGROUND: Successful surgical treatment of late-presenting @entity5249 ( @entity5249 ) @entity1 requires the correction of oblique deformities. The purpose of this study was to report on a new comprehensive approach to correct and prevent recurrence of these deformities with a single procedure. METHODS: Medical records of 23 consecutive @entity1 (7 to 18 y) with advanced @entity5249 (29 knees) were retrospectively reviewed after a mean of 7.3 years postoperatively (range, 2 to 22 y). Indications for the corrective surgery were any @entity1 7 year or older with a varus mechanical axis angle >= 10 degrees or a varus anatomic axis angle >= 11 degrees and a medial tibial angle (MTA) slope <60 degrees. The deformities were corrected with a dome-shaped osteotomy proximal to the tibial tubercle with a midline vertical extension to the subchondral region of the joint and a lateral hemi-epiphysiodesis. RESULTS: At latest follow-up, means and medians of each tibial radiographic axis measurement improved significantly from preoperative values (P<0.001): mechanical axis angle from 23 degrees to 4 degrees varus, anatomic axis angle from 25 degrees varus to 1 degree valgus, MTA downward slope from 30 to 78 degrees, posterior MTA from 59 to 80 degrees. In total, 79% and 74% had good to excellent results based on radiographic criteria and clinical questionnaire for satisfaction, @entity158 and function, respectively. Two abnormal medial tibial plateau types were described. CONCLUSIONS: This is the first study to use a single-stage double osteotomy performed proximal to the tibial tubercle for the late-presenting @entity5249 for @entity1 7 years of age or older. In addition to the effective correction of the 4 major @entity85 , a lateral proximal tibial hemi-epiphysiodesis minimizes recurrence of @entity5249 . A contralateral proximal tibial epiphysiodesis is recommended for treated skeletally immature @entity1 with unilateral disease. LEVEL OF EVIDENCE: Therapeutic level IV. See instructions for authors for a complete description of levels of evidence.

New Single-stage Double Osteotomy for Late-presenting XXXX : A Comprehensive Approach.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient', 'child'] @entity85 :: ('MESH:D009140', 'Disease') :: ['tibial deformities'] @entity5249 :: ('MESH:C536237', 'Disease') :: ['ITV', 'tibia vara', 'infantile tibia vara'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity5249 :: (MESH:C536237,Disease) :: ['Infantile Tibia Vara']
