Transepiphyseal plate osteotomy for severe tibia vara in children: follow-up study of four cases

Transepiphyseal plate osteotomy of the medial tibial condyle was performed in three children (four knees) with severe progressive tibia vara and excessive ligamentous laxity. Two knees with Blount disease underwent tibial valgus osteotomy and epiphysiodesis associated with transepiphyseal plate osteotomy, and two knees with pseudoachondroplasia underwent tibial valgus osteotomy. Follow-up study at the time of skeletal maturity revealed satisfactory alignment of the leg, favorable congruity of the joint, and good ligamentous stability in all cases. Our experience indicates that the present procedures are excellent, although there are very few documented cases and almost no description of the postoperative clinical courses.