Investigators: Mr Paul Harnett, Miss Verona Beckles, Professor Chris Lavy
Stream: Clinical Fellowship
Topic: Lower Limbs/Upper Limbs/Surgical Techniques
Status: Live
Orthopaedic surgeons working in Malawi and neighbouring countries report many cases of 'bow legs' in children. A small number of these fall into the characteristic clinical category of Blount's diseases, with specific pathology seen at the posteromedial aspect of the proximal femoral epiphysis. The majority, however, have mild to severe bowing of the whole length of the tibia associated with internal rotation of the tibia.There have been few prospective studies looking at the aetiology of such deformity and although the name 'rickets' has been loosely used, it is not clear exactly what the underlying condition or conditions are. The patients do not appear to be clinically malnourished and basic biochemistry tests have shown that they are not vitamin D deficient. No medical treatment has been identified to either prevent of reverse the deformity.
The surgical treatment has in the main been tibial osteotomy, with good cosmetic and functional results being obtained in the short term. A literature review found no studies that have looked into the aetiology of this condition in detail, nor has any study attempted to measure post surgical outcome. This study aims to look into the possible aetiology of "Malawian Tibia Vara", the impact it has on children's lives, the results of surgery, and attempt to quantify the improvement in the quality of the surgery achieves through a validated outcome questionnaire modified for the local population.« Back to research projects