Does langenskiold staging have a good prognostic value in late onset tibia vara?

Journal of Orthopaedic Surgery and Research

Ashraf Ahmad Khanfour¹ 

[1] Damanhour National Medical Institute, Ali El-Garim St. In front of Omar Afandi stores, Bohera state, Rasheed, Egypt

关键词: Prognosis;    Ilizarov;    Langenskiold;    Tibia vara;   

Others  :  817913
DOI  :  10.1186/1749-799X-7-23

 received in 2011-04-07, accepted in 2012-04-02,  发布年份 2012

【 摘 要 】

Background

Although many literature studied the effect of many factors on the prognosis of the early-onset Blount disease, studies that were written on the prognostic factors affecting late onset tibia vara are still limited.

Purpose

The aim of this study is to evaluate the prognostic value of the Langenskiold classification system for late onset tibia vara.

Methods

Twenty children from the Sporting Health Insurance Student Reference Hospital – Alexandria, with a diagnosis of late onset tibia vara were evaluated for the effect of the Langenskiold staging system on the prognosis after they all had been treated by gradual correction by Ilizarov technique using the so called “juxta-articular hinge assembly” after a mean follow-up period of 4.9 years (range : 4–6, SD 0.75).

Results

The difference in varus recurrence rates between the “low grade group” and “high grade group” was found to be statistically significant (p = 0.008) as will be discussed later. There was no statistically significant relation between the age of the patients at the time of operation, sex, length of the follow up period and the degree of pre-operative varus deformity angle (DA) and the recurrence (p > 0.05).

Conclusion

We concluded that Langenskiold staging system is a reliable, reproducible and a good prognostic factor for late onset tibia vara.

【 授权许可】

   
2012 Khanfour; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Bradway JK, Klassen RA, Peterson HA: Review article. Blount disease: A review of the english literature. J Pediatr Orthop 1987, 7:472-480.
• [2]Langenskiöld ATibia vara: Osteochondrosis deformans tibiae: blount’s disease. Clin Orthop Relat Res 1981, 158:77-82.
• [3]Langenskiold A: Tibia vara. A critical review. Clin Orthop Relat Res 1989, 246:195-207.
• [4]Sabharwal S: Current concepts review. Blount disease. J Bone Joint Surg Am 2009, 9:1758-1776.
• [5]Thompson GH, Carter JR: Late-onset tibia vara (Blount’s disease). Current concepts. Clin Orthop Relat Res 1990, 255:24-35.
• [6]Langenskiold A, Riska EB: Tibia vara (Osteochondrosis deformans tibiae): a survey of seventy-one cases. J Bone Joint Surg Am 1964, 46:1405-1420.
• [7]Stricker SJ, Edwards PM, Tidwell MA: Langenskiold classification of tibia vara: an assessment of interobserver variability. J Pediatr Orthop 1994, 14:152-155.
• [8]Doyle BS, Volk AG, Smith CF: Infantile Blount disease: long-term follow-up of surgically treated patients at skeletal maturity. J Pediatr Orthop 1996, 16:469-476.
• [9]Ferriter P, Shapiro F: Infantile tibia vara : factors affecting outcome following proximal tibial osteotomy. J Pediatr Orthop 1987, 7:1-7.
• [10]Hofmann A, Jones RE, Herring JA: Blount’s disease after skeletal maturity. J Bone Joint Surg Am 1982, 64:1004-1009.
• [11]Ingvarsson T, Hagglund G, Ramgren B, Jonsson K, Zayer M: Long-term results after adolescent Blount’s disease. J Pediatr Orthop B 1997, 6:153-156.
• [12]Ingvarsson T, Hagglund G, Ramgren B, Jonsson K, Zayer M: Long-term results after infantile Blount’s disease. J Pediatr Orthop B 1998, 7:226-229.
• [13]Coogan PG, Fox JA, Fitch RD: treatment of adolescent Blount disease with the circular external fixation device and distraction osteogenesis. J Pediatr Orthop 1996, 16(4):450-454.
• [14]Gaudinez R, Adar U: Use of orthofix T-Garche fixator in late-onset tibia vara. J Pediatr Orthop 1996, 16(4):455-460.
• [15]Sen C, Kocaoglu M, Eralp L: The advantages of circular external fixation used in high tibial osteotomy (average 6 years follow-up). Knee Surg Sports Traumatol Arthrosc 2003, 11:139-144.
• [16]Stanitski D, Srivastava P, Stanitski C: Correction of proximal tibial deformities in adolescents with the T-Garches external fixator. J Pediatr Orthop 1998, 18(4):512-517.
• [17]Stanitski DF, Dahl M, Louie K, Grayhack J: Management of late-onset tibia vara in the obese patient by using circular external fixation. J Pediatr Orthop 1997, 17(5):691-694.
• [18]Alekberov C, Shevtsov VI, Karatosun V, Giinal I, Alici E: Treatment of tibia vara by the Ilizarov method. Clin Orthop Relat Res 2003, 409:199-208.
• [19]Chotigavanichaya C, Salinas G, Green T, Moseley CF, Otsuka NY: Recurrence of varus deformity after proximal tibial osteotomy in Blount disease : long-term follow-up. J Pediatr Orthop 2002, 22:638-641.
• [20]Eidelman M, Bialik V, Katzman A: The use of the Taylor spatial frame in adolescent Blount’s disease: is fibular osteotomy necessary? J Child Orthop 2008, 2:199-204.
• [21]Loder RT, Schaffer JJ, Bardenstein MB: Late-onset tibia vara. J Pediatr Orthop 1991, 11:162-167.
• [22]Smith SL, Beckish ML, Winters SC, Pugh LI, Bray EW: Treatment of late-onset tibia vara using afghan percutaneous osteotomy and orthofix external fixation. J Pediatr Orthop 2000, 20(5):606-610.
• [23]Gordon JE, Heidenreich FP, Carpenter CJ, Hahn JK, Schoenecker PL: Comprehensive treatment of late-onset tibia vara. J Bone Joint Surg Am 2005, 87:1561-1570.
• [24]Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A: Deformity planning for frontal and sagittal plane correction osteotomies. Orthop Clin North Am 1994, 25:425-465.
• [25]Paley D, Herzenberg JE: Principle of deformity correction. 1st edition. Springer, Berlin; 2002.