Acquired valgus deformity of the tibia in children.

Nine cases of acquired valgus deformity following injury to the proximal tibial metaphysis in children are presented. The deformity is of a dual nature, involving both angular deformity and longitudinal overgrowth. The angular component reaches a maximum within 2 years after the injury. There is some indication that the angular component will remain static or spontaneously correct if treated nonoperatively. Treatment intervention in the majority of the cases has precluded an analysis of the natural history of the longitudinal overgrowth. Early intervention in the form of corrective osteotomy during the growth years has resulted in an unacceptably high rate of recurrence of both components of the deformity. Nonoperative treatment seems to be the treatment of choice for the angular component of valgus deformity following proximal tibial fracture in children. Significant longitudinal overgrowth may be corrected with appropriately timed epiphysiodeses calculated from observed growth rates and skeletal maturational patterns.