IDIOPATHIC GENU-VALGUM TREATED BY EPIPHYSEODESIS IN ADOLESCENCE

Twenty-three patients (13 boys and 10 girls) with the adolescent type of genu valgum were treated by temporary medial epiphyseodesis of both distal femurs with Blount staples (46 knees); 5 also underwent stapli ng of the proximal tibia. Evaluation before the operation and during t he follow up was based on growth charts, photographs and measurement o f the intermalleolar distance. The indication Sat operation was increa sing genu valgum with 10 cm or more of intermalleolar separation; the median distance before operation was 13 cm for boys and 12 cm for girl s. The staples were removed after a median time of 11 months. At skele tal maturity the median intermalleolar separation was 3 cm for boys an d 2 cm for girls. The median frontal angle before operation was 14 deg rees for boys and 6 degrees at follow up, the corresponding figures fo r girls being 14 degrees and 4 degrees. In 2 cases the deformity recur red because the staples were removed too early. In another case a bony bridge formed after the staple was removed and a var us deformity dev eloped; the bridge was resected and the knees became valgus again, but 1 cm of shortening remained on one side. There were no other complica tions.