W/M serrated osteotomy for infantile Blount's disease in Ghana: Short-term results

Purpose: The W/M serrated high tibial osteotomy is a not frequently described surgical technique for simultaneously correcting the varus and torsional deformity in patients with Blount's disease. Without the need for internal fixation, this surgical treatment is well suited for developing countries. This study describes the short-term results of the bilateral and unilateral W/M serrated osteotomy in patients with infantile Blount's disease. Methods: Between May 2008 and January 2013, 52 patients were treated with uni- (n = 22) or bi-lateral (n = 30) W/M serrated osteotomy of the proximal tibia due to a tibial varus deformity in two district hospitals in Ghana. Other causes than infantile Blount's disease were excluded from the analysis. Pre- and post-operative clinical and radiological measurements were done, and complications were monitored up to 12 weeks after surgery. Results: Seventeen patients (five males, 12 females; mean age 4.9 [standard deviation: 2.10]) were included, which underwent a total of 25 W/M serrated osteotomies. The femorotibial angle was corrected from 34.1 degrees ([mean] range: 6u68 degrees) to 7.1 degrees ([mean] range: 28u5 degrees). Only one patient had developed a wound infection, and all reached full consolidation. Conclusions: The W/M serrated osteotomy seems a profitable alternative technique for treating the varus and torsional deformity in patients with Blount's disease in the circumstances of developing countries. The short-term outcomes are good and promising with a low complication rate and good consolidation. Long-term follow-up results of these patients are needed to observe possible complications. Level of Evidence: IV, therapeutic case series.