Four year old female with distal tibial shaft fracture (No Joint Involvement). Required bone to be set due to varus angulation and cast placed. F/u today with x-ray showing 8* varus angulation. Advised that the angulation will self correct 1* per year and be fully corrected at age 12. What is the best course of action? 1: Allow her to heal without surgical correction 2: Surgery. If no surgery, will the tibia be at a weakened state until her 12th birthday?
8 degrees of varus is acceptable in a 4 year old. Once the bone heals completely in 6-12 weeks, it will be as strong as it was before the fracture and not weak. The patient will have full function and normal use of the leg. It should remodel as you were told but it may not remodel completely. However, a few degrees of varus is acceptable for the long term.