NOA Scientific Conference/AGM EKO 2018

Abstract

1 corrEctIon of SEvErE BlountS’ dISEaSE uSIng thE taylor SpatIal fraME In SuB-Saharan afrIca Okunola M.O, Omoyeni A, Uwajeh I.A, Magbagbeola O.A Department of Orthopaedics, University College Hospital, Ibadan, Nigeria. E‐mail: [email protected] Background: Blount’s disease is a developmental condition affecting the posteromedial aspect of the proximal tibial physis, with severity ranging from mild hypoplasia of the medial metaphysis to pre-mature fusion of the medial physis, resulting in a physeal bar. The deformity usually comprises genu varum, procurvatum of the proximal tibia and internal tibial torsion. In severe cases, leg length discrepancies are associated features especially in unilateral cases. The Taylor spatial frame (TSF) developed in 1994 by the Taylor brothers on the basis of hexapod system based on projective geometry utilising a circular external fixator and a computer-based system to determine the programme for the correction of the deformity. It has been found to be valuable in the correction of Blounts’ disease. Case Presentation: We present four patients who presented with severe Blounts’ disease (with a minimum of Langenskiöld Grade V) and had correction of the deformities in five limbs using the TSF. The deformities’ parameters of the four patients range from varus of 5°–60°, procurvatum of 0°–50°, internal tibial torsion of 5°–60° and leg length discrepancies of 4–10 cm. The patients had application of the frame, tibial corticotomy and fibular osteotomy and subsequent gradual deformity correction using the prescribed schedule. Deformities’ correction and leg length equalisation were achieved in all patients except one limb in the bilateral case with residual varus and procurvatum of 5° and 10°, respectively. Residual deformities will require further correction. Conclusion: The TSF is relatively easy to apply and is invaluable in the simultaneous correction of multiaxial limb deformities as those seen in severe Blounts’ disease.