Anterior Opening Wedge High Tibial Osteotomy for Recurvatum Deformity of the Proximal Tibia Secondary to Physeal Arrest: A Dual Site Study
Bibliographic record
Abstract
Context: Injury to the anterior proximal tibial physis or tibial tubercle can result in recurvatum deformity of the tibia. Anterior opening wedge high tibial osteotomy (AHTO) with and without tibial tubercle osteotomy (TTO) can restore posterior tibial slope, improving patient symptoms and function. Aims: Review radiographic and surgical outcomes of patients that undergo AHTO for recurvatum deformity of the proximal tibia. Settings and Design: Patients from two tertiary pediatric institutions with proximal tibial recurvatum treated with an AHTO between 2002 and 2017 were retrospectively reviewed. Materials and Methods: Deformity was assessed radiographically using the posterior proximal tibial angle (PPTA), medial proximal tibial angle, and Caton–Deschamps index (CDI). Surgical techniques and complications were recorded. Statistical Analysis Used: Descriptive statistics were expressed as means and standard deviations. Results: Twelve patients with a mean age of 13.1 years (10–15 years) were included in this study. Acute AHTO proximal to the tibial tubercle was performed in nine cases. Two patients had concurrent TTO. Three patients underwent AHTO with gradual correction with a Circular external fixator with the corticotomy distal to the tibial tubercle. Mean postsurgical follow-up was 6.1 months (1.3–15.6 months). Mean preoperative PPTA improved to within normal for all surgical techniques (AHTO 98.7° to 82.6°, AHTO + TTO 102° to 80.9°, and gradual AHTO 104° to 76.9°). Three patients had residual radiographic hyperextension deformity at last follow-up (PPTA: 85.0°, 87.9°, 94.0°). No clinically significant secondary coronal plane deformities occurred. One patient who underwent acute AHTO had postoperative radiographic patella baja (CDI 0.51). Ten complications (7 Grade I and 3 Grade II) occurred in seven cases. Conclusions: Opening wedge AHTO with acute and gradual techniques corrects the sagittal plane deformity of recurvatum without inducing clinically significant coronal plane deformities, but minor complications are frequent.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".