Dome-Shaped Proximal Tibial Osteotomy For Infantile Genu Varum: Assessment Of Outcomes

Background: The most common deformity of the knee in children is infantile genovarum. We aimed to evaluate the outcome of children with genu varum after proximal tibial dome shaped osteotomy. Patients and methods: a prospective case study was conducted on 12 patients with Persistent physiological infantile genu varum and underwent Dome-Shaped Proximal Tibial Osteotomy. During follow up period, the angle formed by the femoral condyle and the tibial shaft determined by a line drawn parallel to the inferior surface of the femoral condyle intersecting the anatomical axis of the tibia (femoral condyle-tibial shaft angle), normally about 90°, used for assessment of correction in plain X ray to the knee and tibia to avoid need for full length radiograph. All cases were evaluated pre and post-operatively according to Modified Hospital for Special Surgery Knee Scoring System Results: 10 (83.3%) knees had full correction of deformity while 1 knee (8.3%) had under correction and 1 knee (8.3%) showed over-correction of deformity. The mean pre-operative HSSKS scores were 70.16±11.3 while the mean post-operative HSSKS scores were 91.4±2.1. The subjects HSSKS results were improved from pre to post-operatively with a statistically significant difference between them. Conclusion: Dome-Shaped Proximal Tibial Osteotomy is associated with good outcome and the reasonable stability arising from the anteroposterior orientation of the osteotomy and greater surface area for early union, and early weight bearing and active knee exercise indicate a good safety profile and it should be recommended to correct Infantile Genu Varum