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Cozen's deformity: resolved by guided growth.

Matthew Morin1, Joshua Klatt2, Peter M Stevens3

  • 1Department of Orthopedics, University of Utah, Salt Lake City, USA.

Strategies in Trauma and Limb Reconstruction
|March 18, 2018
PubMed
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Guided growth effectively treats post-traumatic tibial valgus in children, restoring the mechanical axis and medial proximal tibial angle. This method offers a predictable solution, minimizing complications associated with other surgical interventions.

Area of Science:

  • Pediatric Orthopedics
  • Pediatric Trauma Surgery

Background:

  • Proximal tibial metaphyseal fractures in children can cause progressive tibial valgus.
  • Traditional corrective osteotomy has high complication rates, including recurrent deformity.
  • Spontaneous remodeling is unpredictable for managing these deformities.

Purpose of the Study:

  • To evaluate the efficacy of guided growth, specifically proximal medial physeal tethering, for correcting post-traumatic tibial valgus in pediatric patients.
  • To assess the long-term outcomes, including deformity correction, recurrence rates, and limb length discrepancies.

Main Methods:

  • Retrospective review of 19 pediatric patients (2 to 13.6 years) treated with guided growth (proximal medial physeal tethering).
  • Interventions included assessment of intermalleolar distance, mechanical axis deviation, medial proximal tibial angle (MPTA), and leg length discrepancy.
Keywords:
Cozen’s phenomenonGuided growthTibial valgus

Related Experiment Videos

  • Implant removal was performed upon mechanical axis normalization; repeat tethering was used for recurrences.

    • Main Results:

    • Correction of mechanical axis and MPTA was achieved in all but one patient.
    • Mean follow-up was 7.3 years; mean limb length discrepancy was 0.5 cm.
    • Five recurrences occurred in four patients, with four successfully re-treated; two overcorrected cases resolved with lateral tethering.

    Conclusions:

    • Guided growth is a successful and predictable management option for post-traumatic tibial valgus in children.
    • The technique effectively restores MPTA and reduces length discrepancies, with manageable recurrence rates.
    • Modified implant removal and reinsertion protocols may help prevent rebound valgus deformity.