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Femoral deformity in tibia vara
J Eric Gordon1, David J King, Scott J Luhmann
1St. Louis Shriners Hospital for Children, 2001 South Lindbergh Boulevard, St. Louis, MO 63131, USA. gordone@msnotes.wustl.edu
The Journal of Bone and Joint Surgery. American Volume
|February 3, 2006
Summary
Compensatory valgus deformity of the femur is not common in infantile tibia vara. Distal femoral varus is a significant component of genu varum in late-onset tibia vara, requiring surgical consideration.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Skeletal deformities
Background:
- Tibia vara (Blount disease) can be associated with compensatory femoral deformity.
- Standing lower extremity radiographs are utilized for quantitative assessment of angular deformities.
Purpose of the Study:
- To quantitatively evaluate the hypothesis of common compensatory valgus deformity of the femur in patients with tibia vara.
- To differentiate femoral deformity in infantile versus late-onset tibia vara.
Main Methods:
- Review of 73 patients (109 limbs) with tibia vara aged two years and older.
- Classification into infantile (37 patients) and late-onset (36 patients) tibia vara.
- Radiographic assessment of distal femoral and proximal tibial angles using standardized standing lower extremity radiographs.
Main Results:
- Infantile tibia vara showed normal or mild distal femoral varus (mean LFDA 97°).
- Late-onset tibia vara exhibited distal femoral varus (mean LFDA 93°), contributing significantly to genu varum.
- Older children with infantile tibia vara had minimal distal femoral valgus (<4°).
Conclusions:
- Substantial distal femoral valgus deformity is uncommon in infantile tibia vara.
- Distal femoral varus is a significant factor in late-onset tibia vara.
- Surgeons should consider distal femoral varus when planning correction for late-onset tibia vara.