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Proximal tibial/fibular osteotomy with acute correction and pin fixation
3%
23/713
Proximal tibial/fibular osteotomy with gradual correction and external fixation
4%
29/713
MRI of the proximal tibial physis
18/713
Medial proximal tibial hemiepiphysiodesis
6%
43/713
Continued observation
83%
594/713
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The tibia has grown into valgus secondary to the proximal fracture. This occurs in about one half of these injuries, and maximal deformity occurs at 18 months postinjury. The deformity gradually improves over several years, with minimal residual deformity. Therefore, treatment at this age is unnecessary as there is a high rate of recurrence and complications regardless of technique. The valgus deformity is not a result of physeal injury or growth arrest. Medial proximal tibial hemiepiphysiodesis is an excellent method of correcting the residual deformity but is best reserved until close to the end of growth.
4.1
(7)
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