Proximal Tibial Recurvatum-Valgus: Analysis and Treatment : JAAOS – Journal of the American Academy of Orthopaedic Surgeons
sseous and ligamentous contributions must be recognized for successful treatment. A graphical planning method identifies the true (oblique) plane of deformity. Surgical treatment options include epiphysiodesis to prevent progressive deformity, guided growth, opening-wedge proximal tibial osteotomy, and gradual correction with concomitant limb lengthening using external fixation or motorized internal lengthening. Opening-wedge proximal tibial osteotomy conducted along the true deformity plane is a reliable surgical method for lesser-magnitude deformities. Gradual correction using circular external fixation is considered when the magnitude of correction is greater than 25º or when limb shortening and/or multiplanar deformity is present. After successful surgical management, patients can expect to achieve correction of knee hyperextension, posterior tibial slope, and mechanical axis. Restoration of these parameters re-establishes physiologic loading of the knee. This review illustrates th