This is a plain-English translation of the academic paper above, prepared for patients, referring clinicians, and other non-specialist readers. It preserves the structure of the original paper while removing technical jargon. For the full clinical paper, follow the PubMed or DOI links.
Background
The case of a young patient who developed genu recurvatum — a knee that bends backwards beyond straight — after a previous fracture at the front of the upper shin bone (a tibial eminence avulsion) had been treated without surgery. We describe how we corrected the deformity with a proximal tibial flexion osteotomy and review the small published literature on this rare problem.
Rationale
Tibial eminence avulsions in children are usually treated successfully without surgery. Very rarely, the front of the growth plate is damaged in the process, so the bone keeps growing at the back but stops growing at the front. The result is a leg that gradually develops backward bend at the knee, which is functionally disabling. Surgical correction options are not well-described in the literature.
Results
The deformity was corrected by cutting the upper shin bone and inserting a wedge-shaped piece of the patient’s own pelvic bone (a tricortical iliac crest graft) to re-tilt the joint surface forward. The wedge of bone was strong enough to hold the correction without metal plates or screws.
Implications
For the small number of patients who develop this kind of growth-related knee deformity after a childhood injury, this case report shows that a proximal tibial flexion osteotomy with a structural bone graft is a reliable correction — a useful option to add to the surgical menu.
Source: Heidari N, Madden JAG, Loeffler MD. Report of a Case of Genu Recurvatum Following Tibial Eminence Avulsion Treated by Proximal Tibial Flexion Osteotomy and Review of the Literature. Surgical Science 2011;2(3):117-120. doi:10.4236/ss.2011.23023
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