Adolescent Blounts with Joint Line Depression Treated with Staged Osteotomies

This is a case of a 13-year-old girl who presented to our service with a right lower limb deformity secondary to Blount’s disease. Comprehensive physical exam and imaging demonstrated a complex deformity: distal femur valgus, proximal tibia varus, tibial internal torsion, and tibial procurvatum. There was also significant medial proximal tibia plateau depression. She was treated with staged deformity correction. The first stage was medial hemi plateau elevation, and the second stage was correction of the limb axis with acute correction of the distal femur and gradual correction of the proximal tibia with a hexapod external fixator (Taylor Spatial Frame, Memphis, USA).