A 7-year-old girl has progressive genu varum after partial arrest of the lateral aspect of the distal femoral physis following neonatal osteomyelitis. She has substantial growth remaining. The most appropriate treatment is:

• A Immediate corrective supracondylar osteotomy of the femur
• B Medial distal femoral hemiepiphysiodesis using a temporary screw ✓
• C Lateral distal femoral hemiepiphysiodesis using a temporary screw
• D Gradual correction with an Ilizarov frame applied across the knee

Explanation

The lateral physeal arrest has left the medial physis growing unchecked, producing varus. In a child with years of growth left, guided growth by tethering the overactive medial side with a temporary screw allows the lateral side to catch up and corrects the deformity gradually. Arresting the lateral side further would worsen varus. An osteotomy corrects position but recurs while the growth asymmetry persists, so it is reserved for severe deformity or near skeletal maturity.

Reference: Tachdjian's Pediatric Orthopaedics, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.