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Natural history of infantile tibia vara Shinohara Y; Kamegaya M; Kuniyoshi K; Moriya HJ Bone Joint Surg Br 2002[Mar]; 84 (2): 263-8We have observed the natural history without treatment of 46 limbs in 29 patients with infantile tibia vara and a metaphyseal-diaphyseal angle (MDA) of more than 11 degrees. The femorotibial angle (FTA) and MDA were measured, and Langenskiold's classification of radiological changes in the proximal medial metaphysis of the tibia was used. In 22 limbs which were not in Langenskiold stages II to III the condition resolved spontaneously without treatment. Of the remaining 24 which were in stages II to III, in 18 it resolved spontaneously by the age of six years, but six showed little or no improvement at the latest follow-up. It was impossible to differentiate by measuring the FTA or MDA whether spontaneous resolution could be expected before the age of four years. There was no difference in the rate of resolution of the deformity between those patients who had been treated by a brace and those who had received no treatment. We advise no initial treatment but review at six-monthly intervals until the age of four years, even in patients with Langenskiold stage-II to stage-III deformity. When a deformity persisted or progressed we carried out a corrective osteotomy after the age of four years.|*Bone Malalignment/therapy[MESH]|*Limb Deformities, Congenital/therapy[MESH]|*Tibia[MESH]|Braces[MESH]|Child, Preschool[MESH]|Female[MESH]|Humans[MESH]|Infant[MESH]|Leg/*abnormalities[MESH]|Male[MESH] |
