Progressive opening-wedge osteotomy for severe tibia vara in adults.

Five patients with tibia vara were treated with progressive opening-wedge osteotomy. The maximum varus deviation of the mechanical axis of the tibia varied from 20 degrees to 12 degrees. The minimum postoperative follow-up was 26 months. Complete correction of the deformity was achieved without any major complications. Progressive opening-wedge osteotomy offers several advantages over conventional osteotomy in adults. First, fibular osteotomy is unnecessary. Second, knee mobility is only slightly restricted immediately following surgery. Third, it is possible to adjust correction postoperatively, and finally, progressive opening-wedge osteotomy does not induce shortening of the lower limb. The most significant disadvantage is the need for prolonged external fixation. This technique should be reserved for patients with severe deformities (minimum of 15 degrees varus) and mild or moderate osteoarthrosis.