Jl. Pinkowski et Ds. Weiner, COMPLICATIONS IN PROXIMAL TIBIAL OSTEOTOMIES IN CHILDREN WITH PRESENTATION OF TECHNIQUE, Journal of pediatric orthopedics, 15(3), 1995, pp. 307-312
Proximal tibial osteotomies in children have been associated with a nu
mber of complications, including peroneal nerve palsies, compartment s
yndromes, deep and superficial infections, vascular injuries, iatrogen
ic fractures, apophyseal or growth plate damage, and recurrence of def
ormity. A retrospective review of the results of 22 children who had 3
0 primary and seven repeat proximal tibial osteotomies was performed t
o assess the frequency of complications at our institution. Using a sp
ecified technique that included prophylactic anterior compartment fasc
iotomy and distal fibulectomy, there were three superficial wound infe
ctions and one delayed union but no peroneal nerve palsies, vascular i
njuries, compartment syndromes, or fixation failures. There were no se
quelae from the superficial infections. This is a lower rate of compli
cations than previously reported in the literature and suggests a rela
tionship to our current surgical technique and attention to detail. We
believe that proximal tibial osteotomies can be performed successfull
y and safely in children when the surgeon recognizes the potential pro
blems and takes steps to prevent them.