This paper examined the results of a tibiofibular osteotomy and external fixation in idiopathic genu varum.

Ten patients (20 cases) with idiopathic genu varum were treated with a tibiofibular osteotomy and external fixation. The average follow-up period was 13 months (range, 6-27). The average age of the patients was 23.1 (range, 16-39). A tibial osteotomy was performed an average 9.1 cm (range, 5-13.5) distal to the tibial spine, which was 2 cm distal to the center of the rotation axis (CORA).

The preoperative anatomical tibio-femoral angle of varus, 7.0o (range, 4-10), was corrected to valgus 0.8o (range, varus 5-valgus 6). After surgery, the femur intercondylar distance of 5.3 cm (range, 4-7) was improved to 0.4 cm (range, 0.5-4), and the preoperative average maximal intercalf distance of 11.2 cm (range, 8.5-13) was improved to 6.5 cm (range, 4-9). A preoperative mechanical axis deviation of 2.0 cm (range, 0-3.5) improved to 0.3 cm (range, 0-2.3). The complications encountered were 4 cases of a pin site infection, 1 case of a superficial peroneal sensory nerve injury, 1 case of a deep peroneal nerve partial injury and 2 cases of a popliteal artery partial occlusion.

The tibiofibular osteotomy and external fixation is considered to be an effective method for treating an idiopathic genu varum with early ROM and weight bearing. However, surgeons need to pay careful attention in order to prevent a neurovascular complications.