Tibial Condylar Valgus Osteotomy for Malunited Proximal Tibial Fractures With Secondary Varus Deformity: A Retrospective Case Report

Malunion following proximal tibial fractures commonly results in coronal plane deformity, altered knee biomechanics, instability, pain, gait disturbance, and progressive medial compartment osteoarthritis. Conventional corrective osteotomies may inadequately address associated intra-articular deformity and joint line incongruity. Tibial condylar valgus osteotomy (TCVO) is a joint-preserving surgical procedure that simultaneously corrects varus malalignment and restores articular congruity. This study aimed to evaluate the radiological and functional outcomes of TCVO in patients with malunited proximal tibial fractures associated with secondary varus deformity. A retrospective case series was conducted involving eight patients who underwent TCVO for malunited proximal tibial fractures. Preoperative and postoperative radiological parameters, including medial proximal tibial angle (MPTA), lateral distal femoral angle, joint line convergence angle (JLCA), correction angle, and wedge size, were assessed. Functional evaluation was performed using the Knee Injury and Osteoarthritis Outcome Score, Lysholm Knee Score, International Knee Documentation Committee (IKDC) score, and Visual Analog Scale (VAS). The mean follow-up duration was 17.5 months. The mean preoperative MPTA improved from 80.5° ± 4.05 to 88.6° ± 4.49 postoperatively. The mean JLCA improved from 4.0° ± 4.52 to 1.28° ± 0.41. The mean correction angle achieved was 6.9° ± 2.37 with an average wedge size of 7.1 ± 3.79 mm. The mean VAS score improved from 5.75 ± 1.48 preoperatively to 4.37 ± 1.84 postoperatively. Restoration of coronal alignment and improvement in joint congruity were achieved in all patients. TCVO is an effective joint-preserving procedure for the management of malunited proximal tibial fractures with associated varus deformity and intra-articular incongruity. The procedure provides reliable radiological correction and satisfactory functional improvement while preserving the native knee joint.