case_images: PMC6942781_01
case_images: At the time of the initial visit to our department, visible valgus deformity of the right knee is noted.
case_images: CRIOR2019-2091932.001.jpg
case_images: PMC6942781_01_CRIOR2019-2091932.001.jpg
case_images: fig1
case_images: A physical examination revealed that the valgus deformity of the right knee was visibly obvious (Figure 1).
case_images: Simple X-ray images taken during the initial visit to our department. Severe valgus deformity is noted with an FTA of 160 degrees and a %MA of 100% from the medial edge of the tibial plateau.
case_images: CRIOR2019-2091932.002.jpg
case_images: PMC6942781_01_CRIOR2019-2091932.002.jpg
case_images: fig2
case_images: X-ray images at the time of the initial visit to our department showed severe valgus deformity with a femoro-tibial angle (FTA) of 160 degrees and % mechanical axis (%MA) of 100% from the medial edge of the tibial plateau (Figure 2).
case_images: Simple X-ray images at the time of injury (age 15). There are no obvious fractures or growth plate fractures.
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case_images: PMC6942781_01_CRIOR2019-2091932.003.jpg
case_images: fig3
case_images: X-ray images taken at the time of injury (at age 15) showed no obvious fractures or growth plate fractures (Figure 3).
case_images: Simple MRI (T2-enhanced) at the time of injury. Mild bone marrow edema in the lateral condyle of the femur and a high signal area suggestive of hemorrhage under the muscular layer are noted.
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case_images: PMC6942781_01_CRIOR2019-2091932.004.jpg
case_images: fig4
case_images: MRI at the time of injury (T2-enhanced) showed mild bone marrow edema in the lateral condyle of the femur and a high signal area suggestive of hemorrhage under the muscular layer (Figure 4).
case_images: X-ray images taken during the four years after the injury showed that the valgus deformity was gradually progressing each year.
case_images: CRIOR2019-2091932.005.jpg
case_images: PMC6942781_01_CRIOR2019-2091932.005.jpg
case_images: fig5
case_images: X-ray images taken during the four years after the injury showed that the valgus deformity was gradually progressing each year (Figure 5).
case_images: A bony bridge on the lateral side of the growth plate was noted on MRI taken at age of 16.
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case_images: PMC6942781_01_CRIOR2019-2091932.006.jpg
case_images: fig6
case_images: A bony bridge on the lateral side of the growth plate was noted on MRI taken at the age of 16 (Figure 6).
case_images: Preoperative planning. mLDFA was planned to improve to 87 degrees and FTA to 178 degrees with a correction of 16 degrees.
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case_images: PMC6942781_01_CRIOR2019-2091932.007.jpg
case_images: fig7
case_images: In preoperative planning, we planned to improve the mLDFA to 87 degrees and FTA to 178 degrees with a 16-degree correction (10 mm closing wedge) (Figure 7).
case_images: X-ray images and appearance of the lower limb six months after surgery. Bone fusion is achieved and %MA is 48.5% from the medial edge of the tibial plateau. Valgus deformity has improved in appearance.
case_images: CRIOR2019-2091932.008.jpg
case_images: PMC6942781_01_CRIOR2019-2091932.008.jpg
case_images: fig8
case_images: Valgus deformity has improved in appearance, whereas lower limb length discrepancy (SMD) improved to -0.5 cm in the left lower limb and the range of motion of the right knee also improved to 0 (extension) to 150 (flexion) degrees (Figure 8).