PROGRESSIVE OPENING-WEDGE OSTEOTOMY FOR ANGULAR LONG-BONE DEFORMITIESIN ADOLESCENTS

We report the treatment in 17 patients of 27 angular deformities of th e long bones by progressive opening-wedge osteotomy. The technique con sists of percutaneous osteotomy and progressive angular correction usi ng a modified Wagner distracter. Ten patients (20 bone segments) had a dolescent bilateral idiopathic tibia vara with a mean angular deformit y of 12 degrees varus (10 to 16). Seven other adolescent patients had secondary angular deformities either at the distal femur or the distal tibia. One of the femoral deformities had an associated 5.5 cm of sho rtening which was treated simultaneously. The patients with idiopathic tibia vara achieved a final mean angular correction of 15 degrees (me chanical axis from 12 degrees varus to 3 degrees valgus). In patients with secondary angular deformities the mean angular correction was 17 degrees. The Wagner device was removed in an average period of 12 week s (9 to 27), and no major complications were observed. Progressive ope ning-wedge osteotomy is an alternative to conventional osteotomies for the treatment of angular deformities of the long bones in adolescent patients, and has the advantage of requiring less invasive surgery, al lowing progressive and adjustable correction with bone lengthening if needed.