Osteotomy of the proximal tibia in the treatment of adolescent tibia vara.

Between 1983 and 1990, 9 patients with 13 involved lower extremities had proximal tibial osteotomies for the treatment of adolescent tibia vara. Average age at the time of onset was 11 years, 8 months. All patients were black and obese. The interval between awareness of the bowleg deformity and presentation averaged 1.7 years. The mean preoperative tibiofemoral angle was 13 degrees varus. Stabilization was achieved by external fixation (6 extremities), crossed pins (4 extremities), or staples (3 extremities). One patient with bilateral deformity experienced multiple postoperative complications including osteomyelitis and recurrent varus deformity at the osteotomy sites, both successfully treated. Another patient had recurrence of the varus deformity and a leg-length discrepancy secondary to early closure of the medial proximal tibial physis. At an average follow-up of 4 years, two patients complained of occasional pain; none complained of pain that restricted normal activities. The mean improvement in the tibiofemoral angle at follow-up was 20 degrees, with a mean tibiofemoral angle of 6 degrees valgus. Overall, there were 10 good, no fair, and 3 poor results.