Congenital posteromedial bowing of the tibia and fibula: treatment option by multilevel osteotomy

Few papers have described patients treated surgically with single osteotomy for congenital posteromedial bowing of the tibia and fibula. Only one paper has described two-level osteotomy for deformity correction: the first for deformity correction and the second for bone lengthening. There are no publications describing the surgical correction of deformation only by the method of multilevel tibial and fibular osteotomy. Research material included four children aged between 3.1 and 5.1 years (average age: 3.7 years) who were operated upon for bowing of the tibia and fibula exceeding 35 degrees in the coronal plane. In all cases, tibial osteotomy was carried out at three or two levels accompanied by fibular osteotomy, and with intramedullary stabilization using K-wires (three patients) or Rush pin (one patient). Follow-up ranged from 3 to 7.7 years. In all cases, axis correction and bone healing were achieved. In large congenital posteromedial bowing of the tibia and fibula, a multilevel tibial and fibular osteotomy may be a better solution than an orthosis or a long time waiting for a spontaneous correction of the deformation. Large circumferential periosteal release that accompanied the surgery influenced the stimulation of bone growth. It may induce the process of lower limbs' equalization not to require the application of intensive surgical procedures.Levels of evidence: Level IV - Case series.