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Volume 5, Problème 4 (2016)

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Surgical Treatment of Childrenâ??s Genu Varum: A Comparison between Two Methods.

Souna BS, Guidah S and Zirbine AS

Introduction: The Genu Varum is physiological from birth till the age of two. It is a reel consultation reason for parents who are often worried seeing this deformation that could cause gait disturbances. Materials and methods: We conducted a retrospective study over a period of 5 years on 50 patients who went through a rickety genu varum surgery. The patients were divided into two groups: Group 1 (correction of the varus by osteotomy and fixation by Blount staples and long leg cast), Group 2 (progressive correction of the varus by the Ilizarov external fixator). The purpose of this study was to compare the results of the two surgical methods. Results: The average age was 6.66 years, with ages ranging from 2 to 15 years. Females accounted for 65% and males 35%, a gender ratio of 1.23. For Group 1 (osteotomy and internal fixation by stapling associated with plaster), the average hospital stay was 22 days (range: 12-50 days). Five cases of hypo-correction and two cases of hypercorrection were recorded. However, we have observed no case of infection and no compression of the plaster under member segment. The plaster was removed within an average of seven (7) weeks. For Group 2 (Ilizarov correction) the average hospital stay was 9 days (range: 10-18 days). The correction by the external IIizarov fixator started on postoperative D2. After the hospitalization, the parents continued the correction. There were no complication or hypo-correction recorded in the Group 2. Discussion: The use of Ilizarov external fixator (progressive correction) did not disrupt the normal process of education of the child because of the reduction in the duration of hospitalization; the child may therefore continue to attend school with the fixative Ilizarov. Conclusion: Surgical correction by osteotomy of genu varum of rickety origin can prevent discomfort and possibly progressive evolution towards knee osteoarthritis later in life.

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