Femoral Deformity in Tibia Vara and Its Response to Growth Modulation.

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Limb deformity correction

Background:

• Tibia vara often involves femoral deformity, impacting overall limb alignment.
• Femoral varus can complicate tibia vara treatment, necessitating evaluation of corrective strategies.

Purpose of the Study:

• To assess the efficacy of lateral tension band plating (LTBP) for correcting femoral varus in patients with tibia vara.
• To compare outcomes of femoral LTBP with non-operative management in cases of associated femoral varus.

Main Methods:

• Retrospective review of 127 limbs undergoing LTBP for tibia vara, with 35 receiving concurrent femoral LTBP.
• Radiographic analysis of mechanical lateral distal femoral angle (mLDFA) and mechanical axis deviation (MAD) pre- and post-treatment.
• Comparison of outcomes between limbs with and without femoral LTBP, stratified by onset of tibia vara (early vs. late).

Main Results:

• Femoral LTBP significantly improved mLDFA, with 80% achieving complete correction.
• In cases with preoperative femoral varus, femoral LTBP correlated with successful correction, particularly in the late-onset group (73% vs. 39% without intervention).
• Limbs without preoperative femoral varus showed minimal change in mLDFA, though 10% developed post-treatment varus.

Conclusions:

• Femoral LTBP is an effective treatment for femoral varus in tibia vara, especially in late-onset cases.
• Observation may be sufficient for early-onset tibia vara with associated femoral varus due to high rates of spontaneous correction.
• Close monitoring for femoral varus development is crucial even in limbs with initially normal femoral alignment during tibia vara treatment.