الفهرس 
Growth in Length of Long BonesOnly 14 pages are availabe for public view
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Abstract
Tibia vara was described by Blount in 1937. The 6
radiographic stages classification proposed by Langenskiöld and Riska
in 1964 represents the progression of the disease if left untreated.
The etiology of tibia vara remains unknown, however it was
proposed that growth arrest of the posteromedial aspect of the proximal
tibial physis is due to increased compressive forces on the medial side
with tensile forces applied on the lateral aspect.
Early aggressive treatment of tibia vara is recommended
before development of complex deformities of the proximal tibia with
depression of the tibial plateau. The earlier the management and stage
of disease, the less likely the incidence of recurrence. The management
of early stages consists mainly of a metaphyseal valgus osteotomy to
alter the compressive forces on the medial physis to tensile forces.
In adolescent Blount disease, the radiographic appearance of
the tibial physis is relatively normal, there is widening of the proximal
medial physeal plate. True bony bridges have rarely been demonstrated.
A final mechanical axis of 0 to 5° varus is advised. The preoperative
plan must assess the distal femoral deformity.
Several techniques have been proposed for the surgical
management of severe cases of tibia vara. Such techniques include
metaphyseal valgus osteotomy, hemi-epiphysiodesis, physeal bar
resection, asymmetrical physeal distraction.
The use of physeal distraction is limited because of the risk of
physeal closure.