Genu varum deformity due to premature epiphyseal closure after treatment with isotretinoin for neuroblastoma: A case report.

Abstract

Isotretinoin, a vitamin A derivative, is known to induce premature epiphyseal closure. We report the case of a 9-year-old boy with neuroblastoma who demonstrated premature epiphyseal closure after 1 year of isotretinoin treatment (72.3 mg/m2/day). A bone bridge developed on the bilateral proximal tibial growth plate resulting in genu varum. We performed hemiepiphysiodesis on the bilateral proximal tibia in anticipation of the spontaneous resolution of the bone bridge. Genu varum on the left side was corrected with the resolution of bone bridge. For the remaining bone bridge on the right side, arthroscopy-assisted physeal bar resection was performed, and genu varum on the right lower extremity was also corrected. A regular review of the alignment of the upper and lower limbs is necessary to provide timely intervention in patients using isotretinoin, considering the possibility of premature epiphyseal closure.

• Authors: Won Keun Park, Hyoung Soo Choi, Chin Youb Chung, Moon Seok Park, Ki Hyuk Sung
• Journal: Journal of orthopaedic surgery (Hong Kong) (J Orthop Surg (Hong Kong)) 2020 Jan-Apr Vol. 28 Issue 2 Pg. 2309499020924483 ISSN: 2309-4990 [Electronic] England
• PMID: 32425129 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Dermatologic Agents
• Isotretinoin

Topics

• Arthroscopy (methods)
• Child
• Dermatologic Agents (adverse effects)
• Genu Varum (diagnosis, etiology, surgery)
• Humans
• Isotretinoin (adverse effects)
• Male
• Neuroblastoma (drug therapy)
• Osteotomy (methods)
• Tibia (diagnostic imaging, surgery)