? blount's L tibia withTAR synd radial clubhand

[CHERRY KOVOOR]

Dear Friends

Kindly give your opinion

8 yr. old boy  case of TAR syndrome -bilateral radial club hand and thrombocytopenia treated initially with platelet transfusion

Varus deformity L upper tibia more pronounced on walking with lateral thrust  with severe internal rotation deformity and shortening 2.5 cm

Xrays [taken with patella facing forward and pelvis levelled]  show varus due to ?sloping of medial tibial condyle and metaphyseal beaking and NO METAPHYSEAL VARUS]

[Previous xrays with pelvis not squared failed to show any deformity  pic  flxrayscropapril.jpg 2021]

Is it some form of Blount’s?

My plan would be after correction of thrombocytopenia and anaesthetic fitness

Stage I-Arthrogram and intra epiphyseal osteotomy and elevation and strut grafting

Stage II- Lengthening and de rotation correction with Ilizarov

Should I do an MRI to determine intra articular depression of medial tibial condyle before any procedure

Gait pics athttps://youtu.be/CbGQAfsElSo

    Attaching clinical and x-rays pics

PERMISSION TAKEN FROM PARENTS TO DISCUSS THE CASE IN ACADEMIC FORUMS

   Regards

  DR CHERIYAN KOVOOR

  KOCHI   INDIA