Blount disease


Ref2242ed to as tibia vara.

Associated with bowing of the knees at the proximal tibia.

Affects only the proximal tibial epiphysis.

Radiographic changes of beaking of the metaphysis, calcification and widening of proximal tibial epiphyseal plate medically.

Produces a varus deformity at the knee.

Seen primarily in obese or large black children and adolescents who begin walking early.

Creates excessive force in the medial physis of the proximal tibia and inhibits the normal growth of this bone, while the lateral physis grows normally, producing knee bowing.

May be a unilateral or bilateral process.

Blount’s disease is a growth disorder of the tibia that causes the lower leg to angle inward, resembling a bowleg.

Occurs in young children and adolescents.

Cause is unknown but thought to be due to the effects of weight on the growth plate.

The inner part of the tibia fails to develop normally, causing angulation of the bone.

As the child develops it is progressive and the process worsens.

More common among children of African ancestry.

Associated with obesity, short stature, and early walking.

There does not appear to be an obvious genetic factor.

Clinical examination shows that the lower legs angle inward, and x-rays of the knee and the lower leg confirm the diagnosis.

Treatment varies with patient age and stage of the disease.

Bracing, surgery are treatment options.

In children who develop severe bowing before the age of 3 may be treated with knee ankle foot orthoses.

Bracing may fail, or bowing may not be detected until the child is older so that some cases require surgery to realign the tibia or even to lengthen it.

Other times, the growth of just the outer half of the tibia can be surgically restricted to allow the child’s natural growth to reverse the bowing process.

In situations where bowing is minor and significant time for growth remains the growth of the outer half of the tibia can be surgically restricted to reverse the bowing process.

With appropriate management normal function and cosmetic appearance is expected.

Inadequate care may lead to progressive deformity, and leg-length discrepancy.

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