{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T16:45:31Z","timestamp":1784911531449,"version":"3.55.0"},"reference-count":23,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"5","license":[{"start":{"date-parts":[[2005,5,1]],"date-time":"2005-05-01T00:00:00Z","timestamp":1114905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2005,5]]},"abstract":"<jats:p> We reviewed 34 knees in 24 children after a double-elevating osteotomy for late-presenting infantile Blount\u2019s disease. The mean age of patients was 9.1 years (7 to 13.5). <\/jats:p><jats:p> All knees were in Langenski\u00f6ld stages IV to VI. The operative technique corrected the depression of the medial joint line by an elevating osteotomy, and the remaining tibial varus and internal torsion by an osteotomy just below the apophysis. In the more recent patients (19 knees), a proximal lateral tibial epiphysiodesis was performed at the same time. <\/jats:p><jats:p> The mean pre-operative angle of depression of the medial tibial plateau of 49\u00b0 (40\u00b0 to 60\u00b0) was corrected to a mean of 26\u00b0 (20\u00b0 to 30\u00b0), which was maintained at follow-up. The femoral deformity was too small to warrant femoral osteotomy in any of our patients. The mean pre-operative mechanical varus of 30.6\u00b0 (14\u00b0 to 66\u00b0) was corrected to 0\u00b0 to 5\u00b0 of mechanical valgus in 29 knees. In five knees, there was an undercorrection of 2\u00b0 to 5\u00b0 of mechanical varus. At follow-up a further eight knees, in which lateral epiphysiodesis was delayed beyond five months, developed recurrent tibial varus associated with fusion of the medial proximal tibial physis. <\/jats:p>","DOI":"10.1302\/0301-620x.87b5.15473","type":"journal-article","created":{"date-parts":[[2005,4,26]],"date-time":"2005-04-26T18:53:15Z","timestamp":1114541595000},"page":"710-715","source":"Crossref","is-referenced-by-count":38,"title":["Double-elevating osteotomy for late-presenting infantile Blount\u2019s disease"],"prefix":"10.1302","volume":"87-B","author":[{"given":"A. L.","family":"van Huyssteen","sequence":"first","affiliation":[{"name":"Department of Orthopaedics 26 Dreyer Road, Kommetjie 7975, South Africa, 500 Claremont Hospital, Claremont 7800, South Africa, Stable Lodge, 15 St Marks Road, Smith\u2019s, FL06, Bermuda, Department of Orthopaedics University of Cape Town, 7 Marne Avenue, Newlands 7700, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Hastings","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics 26 Dreyer Road, Kommetjie 7975, South Africa, 500 Claremont Hospital, Claremont 7800, South Africa, Stable Lodge, 15 St Marks Road, Smith\u2019s, FL06, Bermuda, Department of Orthopaedics University of Cape Town, 7 Marne Avenue, Newlands 7700, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Olesak","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics 26 Dreyer Road, Kommetjie 7975, South Africa, 500 Claremont Hospital, Claremont 7800, South Africa, Stable Lodge, 15 St Marks Road, Smith\u2019s, FL06, Bermuda, Department of Orthopaedics University of Cape Town, 7 Marne Avenue, Newlands 7700, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. B.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics 26 Dreyer Road, Kommetjie 7975, South Africa, 500 Claremont Hospital, Claremont 7800, South Africa, Stable Lodge, 15 St Marks Road, Smith\u2019s, FL06, Bermuda, Department of Orthopaedics University of Cape Town, 7 Marne Avenue, Newlands 7700, Cape Town, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"R1","unstructured":"Blount WP. Tibia vara: osteochondrosis deformans tibiae. J Bone Joint Surg 1937; 19:1\u201329."},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Langenski\u00f6ld A, Riska EB. Tibia vara (osteochondrosis deformans tibiae): a survey of seventy-one cases. J Bone Joint Surg [Am] 1964;46-A:1405\u201320.","DOI":"10.2106\/00004623-196446070-00002"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198707060-00002"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198264070-00006"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199607000-00009"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.45B2.320"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199274030-00005"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198202010-00012"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"St\u00f8ren H. Operative elevation of the medial tibial joint surface in Blount\u2019s disease. Acta Orthop Scand 1970;40:788\u201396.","DOI":"10.3109\/17453676908989543"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Sasaki T, Yagi T, Monji J, Yasuda K, Kanno Y. Transepiphyseal plate osteotomy for severe tibia varus in children: follow-up study of four cases. J Pediatr Orthop 1986; 6:61\u20135.","DOI":"10.1097\/01241398-198601000-00013"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198903000-00012"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197052040-00011"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Paley D, Tetsworth K. Mechanical axis deviation of the lower limbs: preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop 1992; 280:48\u201364.","DOI":"10.1097\/00003086-199207000-00008"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199903000-00025"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199203000-00010"},{"key":"R16","unstructured":"van Huyssteen AL, Davies JQ, Hastings CJ, Hoffman EB, Roche SJL. Late-onset Blount\u2019s disease: an epidemiological, radiological and histological study. J Bone Joint Surg [Br] 2001;83-B (Supp 1):4."},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198401000-00016"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198803000-00012"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199503000-00021"},{"key":"R20","unstructured":"Moseley CF. Leg length discrepancy. In: Morrissey RT, Weinstein SL, eds. Lovell and Winter\u2019s paediatric orthopaedics. Vol. 2. Philadelphia: Lippincott, Williams &\n Wilkins, 2001:1105\u2013150."},{"key":"R21","doi-asserted-by":"crossref","unstructured":"Anderson M, Green WT, Messner MB. Growth and predictions of growth in the lower extremities. Am J Orthop 1963;45-A:1\u201314.","DOI":"10.2106\/00004623-196345010-00001"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B4.13602"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200311000-00012"}],"container-title":["The Journal of Bone and Joint Surgery. 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