Orthotic treatment of infantile tibia vara

Difficulty differentiating physiologic genu varum from early Blount's disea se persists. Drennan's metaphyseal-diaphyseal (MD) angle remains the most c onsistently valuable radiographic parameter despite measurement error. Clin ical risk factors also should be considered. All patients receiving orthose s for genu varum since 1985 were reviewed. The focus of the study was those patients with an MD angle of >16 degrees or between 9 and 16 degrees with a clinical risk factor for progression. Risk factors considered were ligame ntous instability, obesity, asymmetry, and being female, black, or Hispanic . Thirty-eight patients with 60 tibiae were included. The success rate was 90%. Risk factors for failure (six cases) were instability, obesity, and de layed bracing. In cases with MD angles >16 degrees, the success rate was 86 %. The results of orthotic treatment, restricted to patients meeting the st ated parameters, represent improvement on the reported natural history.