Complications of osteotomies about the knee in children.

Eighteen years experience performing osteotomies about the knee in children is reviewed. The underlying pathology producing the angular deformity included rickets, Blount's disease, epiphyseal and metaphyseal injuries, physiologic angulation, benign tumors, cartilage disorders, and muscle imbalance due to polio, meningomyelocele, cerebral palsy, and soft tissue tumors. Sixty-five procedures were performed by a variety of techniques with the majority being on the proximal tibia.Postoperative complications were numerous with 63% of the patients having one or more. These complications included loss of alignment, vascular complications, pathologic fractures, wound infection, anterior and posterior angulation at the osteotomy site, tibial tubercle prominence and patellofemoral malalignment.A thorough understanding of the underlying disease process and its usual clinical course, an appreciation of the pertinent surgical anatomy, and an awareness of the potential complications are all needed to obtain the best results when dealing with angular deformities about the knee in children.