Post-infection physeal bar resection of the proximal tibia: a case report and narrative review of the literature.

The formation of physeal bars following growth plate injuries can cause complications such as limb length discrepancies and angular or physeal deformities. Physeal bars usually form after fractures but can also develop due to infectious processes. Management strategies depend on factors such as the bar's location, extent and residual growth potential. We describe the case of a two-year-old female with a lower limb discrepancy and a slight varus knee deformity caused by a proximal tibial physeal bar due to a neonatal infection. The severe anatomical epiphyseal anomaly of her right proximal tibia had developed into a consistent joint irregularity. At 26 months old, the patient underwent a physeal bar resection, assisted by arthroscopy and intraoperative C-arm imaging. This minimally invasive technique facilitated safe, accurate removal of the lesion, avoiding any resection of healthy physeal cartilage. Postoperative outcomes were favourable, including restored range of knee motion and full symptom resolution. This approach demonstrated the clinical value of integrating arthroscopy equipment assistance with intraoperative C-arm imaging during the surgical treatment of physeal bars.