{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T22:25:30Z","timestamp":1748298330151,"version":"3.40.5"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004156","name":"Mahidol University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine Siriraj Hospital, Mahidol University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010794","name":"Faculty of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the radiographic outcomes following dome or wedge\u2010shaped proximal tibial osteotomy in the management of infantile Blount disease with a particular interest in sagittal alignment of the knee joint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Medical records of patients with Langenski\u00f6ld stage 2 Blount disease (aged \u22645\u2009years) who underwent surgical correction between January 2005 and November 2019 were retrospectively identified. Patients with metabolic bone disease, bone tumors, prior traumatic fractures, congenital anomalies, inadequate plain films, and incomplete medical documents were excluded. Patient characteristics (e.g. age, gender, and body mass index [BMI]) and surgical characteristics (e.g. side, type of surgery, and follow\u2010up times) were recorded. Antero\u2013posterior (AP) and lateral knee radiographs were analyzed. Data were categorized by surgical technique as dome\u2010shaped proximal tibial osteotomy or wedge\u2010shaped proximal tibial osteotomy. The femorotibial angle (FTA) was used to evaluate the correction angle in varus deformities. Sagittal alignment of the lower limbs using the posterior tibial slope (PTS) angle was measured postoperatively at 3, 6, 12, and 24\u2009months, and at the final follow\u2010up visit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The present study included 72 surgeries of 46 patients who had undergone proximal tibial osteotomy. Twenty\u2010nine (63%) were male. The mean age of patients at the time of surgery was 34.50\u2009months (range, 26\u201347). The mean weight was 23.11\u2009\u00b1\u20094.98 kg (mean\u2009\u00b1\u2009SD); the mean height was 95.33\u2009\u00b1\u20096.36 cm, and the mean BMI was 25.32\u2009\u00b1\u20094.36 kg\/m<jats:sup>2<\/jats:sup>. The mean duration of follow up was 4.77\u2009\u00b1\u20092.78\u2009years. Sixty\u2010four patients (88.90%) received dome\u2010shaped proximal osteotomy of the tibia, while 8 (11.10%) received wedge\u2010shaped proximal osteotomy of the tibia. The average FTA of the total correction measured was 29.32\u00b0\u2009\u00b1\u20097.98\u00b0. The demographic data of the two groups were not significantly different for gender, age, BMI, side follow\u2010up times, and the total correction of varus deformities. In the dome\u2010shaped osteotomy group, the mean correction of the FTA was 29.59\u00b0\u2009\u00b1\u20097.45\u00b0. The mean degree of the PTS angle was 6.50\u00b0 at 3\u2009months, 6.38\u00b0 at 6\u2009months, 5.32\u00b0 at 12\u2009months, 5.17\u00b0 at 24\u2009months, and 5.53\u00b0 at the final follow\u2010up visit. In the wedge\u2010shaped proximal tibial osteotomy group, the mean correction of the FTA was 27.25\u00b0\u2009\u00b1\u200911.77\u00b0. The PTS was 6.00\u00b0 at 3\u2009months, 7.50\u00b0 at 6\u2009months, 7.00\u00b0 at 12\u2009months, 5.40\u00b0 at 24\u2009months, and 5.57\u00b0 at the final follow\u2010up visit. No significant difference was observed in the radiological outcome between surgical techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dome and wedge\u2010shaped proximal tibial osteotomies did not demonstrate significant differences in the PTS angle in children with Blount disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12674","type":"journal-article","created":{"date-parts":[[2020,4,17]],"date-time":"2020-04-17T00:55:04Z","timestamp":1587084904000},"page":"770-775","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Do Different Tibial Osteotomy Techniques Affect Sagittal Alignment in Children with Blount Disease?"],"prefix":"10.1111","volume":"12","author":[{"given":"Piyanuch","family":"Musikachart","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Siriraj Hospital, Mahidol University  Bangkok Thailand"},{"name":"Department of Orthopaedic Surgery Siriraj Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2634-1175","authenticated-orcid":false,"given":"Perajit","family":"Eamsobhana","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Siriraj Hospital, Mahidol University  Bangkok Thailand"},{"name":"Department of Orthopaedic Surgery Siriraj Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"1","article-title":"Tibia vara: osteochondris deformans tibiae","volume":"19","author":"Blount WP","year":"1937","journal-title":"J Bone Joint Surg"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e31803433c3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2018.01.009"},{"key":"e_1_2_7_5_1","first-page":"29","article-title":"Blount disease. 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