title: Treatment of late-onset tibia vara using afghan percutaneous osteotomy and orthofix external fixation.
abstract: The Afghan osteotomy was combined with external fixation on 19 patients (23 extremities) with late-onset tibia vara. The average weight was 258 lb and all patients weighed >95th percentile. The average preoperative deformity was 28.2 degrees. The average intraoperative correction was 27.6 degrees. Average healing time was 141 days. The mean follow-up was 2.7 years. Based on radiographic correction, at long-term follow-up, there were 15 excellent, two fair, and six poor results. The quality of the initial correction was the only significant variable, and it was borderline (p = 0.0587). Complications included loss of alignment, peroneal nerve palsy, superficial pin tract infection, deep infection, and fracture. This method offers a technically simple procedure with a relatively low complication rate. It allows early mobilization and provides the ability to manipulate the correction postoperatively. An excellent long-term outcome is predicated on achieving an acceptable initial correction as determined by intraoperative mechanical axis radiographs.
authors.affiliation: Charlotte Orthopaedic Specialists, North Carolina, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Smith
authors.forename: M L
authors.initials: ML
authors.lastname: Beckish
authors.forename: S C
authors.initials: SC
authors.lastname: Winters
authors.forename: L I
authors.initials: LI
authors.lastname: Pugh
authors.forename: E W
authors.initials: EW
authors.lastname: Bray
mesh_terms: D000293:Adolescent; D001848:Bone Diseases, Developmental / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D002648:Child; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications; D010007:Osteochondritis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors