Spatial frame correction of anterior growth arrest of the proximal tibia: report of three cases

We report three cases of anterior growth arrest of the tibia in adolescent boys. Two of the three cases had a clear history of trauma and although there was a history of trauma in the third case, the patient also had human leukocyte antigen-B27 negative enthesitis that had not previously affected the knee. In all cases, a slowly deteriorating hyperextension of the knee developed that in the two posttraumatic cases was initially misinterpreted as a posterior cruciate ligament injury. Radiographs demonstrated an abnormal relationship between the tibial plateau and the long axis of the tibia on the lateral view--anatomical posterior proximal tibial angle. All patients were successfully treated by the Taylor spatial frame with correction of the anatomical posterior proximal tibial angle to normal, equalization of the legs and correction of any concomitant coronal deformity. Hyperextension of the knee developing after an injury in adolescents should raise the suspicion of anterior growth arrest prompting careful analysis of the lateral radiograph.