Advanced tibia vara (Blount disease) in adolescent Nigerians

Twenty-five cases of advanced tibia vara occurring in adolescent Nigerians treated at the University College Hospital, Ibadan, are reported. They were aged from 11 to 14 years. The severity of the condition was assessed by measuring the intercondylar distance of the knees, radiological appearance, and measurement of the femorotibial angles. The condition is characterized by failure of growth of the posteromedial part of the proximal part of tibial epiphysis, the deformity producing acute varus at the upper end of the tibia with medial torsion and ultimately with flexion of the diaphysis on epiphysis. The deformity leads to early degenerative changes in the knee.The decision to correct the deformity by tibial osteotomy was not only for cosmetic reasons but also to prevent knee osteoarthritis at a later date. The operation in experienced hands gives satisfactory cosmetic appearance with few complications except for the tendency of the scars to be keloidal, broad, and conspicuous.