Late Onset Deformity in a Healed Fracture: A Case of Paediatric Post Traumatic Tibia Valga


Total Views: 221 | Total Downloads: 110

Authors

  • Sakinah Mohd Razali Orthopaedics Unit, Surgical-Based Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia
  • Mohd Ash'ari Bain Orthopaedics Unit, Surgical-Based Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia
  • Mohd Hilmi Nazarallah Orthopaedics Unit, Surgical-Based Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia
  • Nur Dina Azman Orthopaedics Unit, Surgical-Based Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia
  • Abu 'Ubaidah Norazmi Orthopaedics Unit, Surgical-Based Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia

DOI:

https://doi.org/10.33102/mjosht.v9i2.273

Keywords:

fracture, metaphyseal, tibia, genu valgum, Cozens phenomenon

Abstract

Post traumatic tibial valga, also known as Cozen’s phenomenon, is a condition of a pathologic knee valgus with variable limb shortening in the affected limb. It is a late-onset complication following a previously healed fracture of the proximal tibial metaphases. The deforming nature of the condition raises much concern for patients and their carers. Despite the appearance of deformity, the child is frequently asymptomatic. It can be treated successfully with watchful waiting and supervised neglect that can potentially span over a few years. In this case report, we emphasise the early recognition of patients at risk of this unique complication. As illustrated in this case report, not all deformity needs surgery. 

Downloads

Download data is not yet available.

References

Baig MN. A review of epidemiological distribution of different types of fractures in paediatric age. Cureus. 2017 Aug;9(8). doi:10.7759/cureus.1624

Yang BW, Shore BJ, Rademacher E, May C, Watkins CJ, Glotzbecker MP. Prevalence of Cozen’s Phenomenon of the Proximal Tibia. Journal of pediatric orthopedics. 2019 Feb. doi:10.1097/BPO.0000000000001354

Hobson TE, Mortensen AJ, Metz AK, Aoki SK. Cozen’s Phenomenon After Repair of a Medial Collateral Ligament Periosteal Avulsion in a Pediatric Athlete: A Case Report. JBJS Case Connector. 2021 Oct 1;11(4):e21. doi:10.2106/JBJS.CC.21.00481

Cozen L. Fracture of the proximal portion of the tibia in children followed by valgus deformity. Surgery, gynecology & obstetrics. 1953 Aug;97(2):183-8.

Burton A, Hennrikus W. Cozen’s fracture theories organised by article. Journal of pediatric orthopedics. Part B. 2016 May.

Dorman S, Jariwala A, Campbell D. Cozen’s phenomenon: a reminder. Scottish medical journal. 2013 Aug;58(3):e10-3. doi:10.1177/0036933013496922

Tileston K, Frick S. Proximal Tibial fractures in the pediatric population. The Journal of Knee Surgery. 2018 Jul;31(06):498-503.

Papamerkouriou YM, Tsoumpos P, Tagaris G, Christodoulou G. Does Cozen’s phenomenon warrant surgical intervention?. Journal of Children’s Orthopaedics. 2020 Jun;14(3):213-20. doi:10.1302/1863-2548.14.19014

Tuten HR, Keeler KA, Gabos PG, Zionts LE, Mackenzie WG. Posttraumatic tibia valga in children. A long-term follow-up note. JBJS. 1999 Jun 1;81(6):799-810.

Nenopoulos S, Vrettakos A, Chaftikis N, Beslikas T, Dadoukis D. The effect of proximal tibial fractures on the limb axis in children. Acta orthopaedica belgica. 2007 Jun 1;73(3):345.

Morin M, Klatt J, Stevens PM. Cozen’s deformity: resolved by guided growth. Strategies in Trauma and Limb Reconstruction. 2018 Mar 1:1-7.

Müller I, Muschol M, Mann M, Hassenpflug J. Results of proximal metaphyseal fractures in children. Archives of orthopaedic and trauma surgery. 2002 Jul 1;122(6):331-3. doi:10.1007/s00402-002-0413-8

Khanfour AA, el-Rosasy M. Cozen’s phenomenon: state-of-the-art management taking the advantages of recent advances in growth modulation with critical review’. Acta Orthopaedica Belgica. 2020 Jun 1;86(S 2):79-86.

[Stevens PM, Pease F. Hemiepiphysiodesis for posttraumatic tibial valgus. Journal of Pediatric Orthopaedics. 2006 May 1;26(3):385-92. doi:10.1097/01.bpo.0000206515.84577.70

Published

2023-09-12
CITATION
DOI: 10.33102/mjosht.v9i2.273
Published: 2023-09-12

How to Cite

Mohd Razali, S., Bain, M. A., Nazarallah, M. H., Azman, N. D., & Norazmi, A. ’Ubaidah. (2023). Late Onset Deformity in a Healed Fracture: A Case of Paediatric Post Traumatic Tibia Valga. Malaysian Journal of Science Health & Technology, 9(2), 87–89. https://doi.org/10.33102/mjosht.v9i2.273

Issue

Section

Orthopaedics