PMC4839021_01
PMC4839021_02
a Preoperative magnetic resonance, b 4 months postoperative radiograph showing the slope of the tibial epiphysis screws, c patient at 4 months after surgery with valgus knee deviation, d patient at 1 year and 2 months after surgery, with fixed valgus deformity and e 1 year and 2 months postoperative radiograph showing fibula hypertrophy, screws tilt correction and growth of 0.75 cm and f radiography postoperative 2 years and 2 months with growth of 1.2 cm
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Fig7
In this case, we did not use fix angle screws in the proximal plate, which resulted in valgus deviation that was clinically observed and radiographically evidenced by tilting of the screws (Fig. 7a-c). The patient underwent the first scanometry of the lower limbs one year after surgery, when 0.75 cm fibular growth was observed and reorientation of the screws was done (Fig. 7b-e). The second scanometry, held 26 months postoperatively, demonstrated 1.2 cm growth of the transposed fibula (Fig. 7f).
a patient 3 years and 7 months postoperatively, at full load, b 3 years, 7 months, bending under load and good function of the knee, and c radiograph 3 years, 7 months, fibula hypertrophied, already fully tibializated
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Fig8
He has equalized, satisfactory functioning lower limbs (Additional file 6: Video 6) (Fig. 8).
PMC4839021_03
a  The proximal-plate with a horizontal support, for proximal tibia epiphisial support, b immediate postoperative radiograph, c 3 months postoperative radiograph, showing the distal tibio-fibular consolidation and d 6 months postoperative radiograph, showing hypertrophy the fibula
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Fig9
In this case, the proximal plate was improved by creating a support to the remaining tibial plateau, aiming to improve stability and prevent angular deviations (Fig. 9b). Distal bone healing and initial fibular hypertrophy were radiographically confirmed (Fig. 9c, d).