Blount's Disease: Difference between revisions
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Blount's disease, also known as tibia vara, is a growth disorder of the tibia (shin bone) that causes the lower leg to angle inward, resembling a bowleg.<br> | Blount's disease, also known as tibia vara, is a growth disorder of the tibia (shin bone) that causes the lower leg to angle inward, resembling a bowleg.<br> | ||
Blount's disease occurs in young children and adolescents. The cause is unknown but is thought to be due to the effects of weight on the growth plate. The inner part of the tibia, just below the knee, fails to develop normally, causing angulation of the bone. Unlike bowlegs, which tend to straighten as the child develops, Blount's disease is progressive and the condition worsens. It can cause severe bowing of the legs and can affect one or both legs. | Blount's disease occurs in young children and adolescents. The cause is unknown, but is thought to be due to the effects of weight on the growth plate. The inner part of the [[tibia]], just below the [[knee]], fails to develop normally, causing angulation of the bone. Unlike bowlegs, which tend to straighten as the child develops, Blount's disease is progressive and the condition worsens. It can cause severe bowing of the legs and can affect one or both legs. | ||
This condition is more common among children of African ancestry. It is also associated with obesity, short stature, and early walking. There does not appear to be an obvious genetic factor. | This condition is more common among children of African ancestry. It is also associated with obesity, short stature, and early walking. There does not appear to be an obvious genetic factor. | ||
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== Clinically Relevant Anatomy == | == Clinically Relevant Anatomy == | ||
add text here relating to '''''clinically relevant''''' anatomy of the condition<br> | add text here relating to '''''clinically relevant''''' anatomy of the condition<br> | ||
== Etiology / Epidemiology == | |||
The cause of Blount's disease is assumed to be multifactoral, mostly mechanically due to childhood obesity.<ref name=":0">Sabharwal S. [https://s3.amazonaws.com/academia.edu.documents/41528057/Blount_CCR_JBJS.pdf?response-content-disposition=inline%3B%20filename%3DBlount_CCR_JBJS.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=ASIATUSBJ6BAI2IGOEXQ%2F20200501%2Fus-east-1%2Fs3%2Faws4_ Blount disease.] Journal of Bone and Joint Surgery 2009;91(7):1758-76.</ref> | |||
== Mechanism of Injury / Pathological Process == | == Mechanism of Injury / Pathological Process == | ||
Blount's disease is catagorised into early-onset if it develops in children under 4 years old, and late-onset, when it develops after the age of 4.<ref name=":0" /> | |||
<br> | |||
== Clinical Presentation == | == Clinical Presentation == | ||
Multiplanar deformities of the lower leg includes:<ref name=":0" /> | |||
* [[Tibia|Tibial]] varus | |||
* Procurvatum | |||
* Internal torsion | |||
* [[Leg Length Discrepancy|Limb shortening]] | |||
* Distal [[Femur|femoral]] varus (in late-onset)<br> | |||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
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add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]]) | add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]]) | ||
== | == Medical management == | ||
=== Conservative management === | |||
Children who develop severe bowing before the age of 3 may be treated with bracing. However, bracing may fail, or bowing may not be detected until the child is older. | |||
=== Surgical management === | |||
* Realignment tibial osteotomy: To be done before the age of 4 to decrease the risk of recurrent lower extremity deformity and to restore leg length where needed.<ref name=":0" /> | |||
* Distraction osteogenesis: For late-onset disease:<ref name=":0" /> | |||
** Aim to achieve multiplanar correction | |||
* 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. This much smaller surgery is most effective in children with less severe bowing and significant growth remaining.<ref name=":0" /> | |||
<br> | |||
== Differential Diagnosis == | == Differential Diagnosis == | ||
add text here relating to the differential diagnosis of this condition<br> | add text here relating to the differential diagnosis of this condition<br> | ||
<br> | |||
== Resources == | == Resources == | ||
Revision as of 23:25, 1 May 2020
This article is currently under review and may not be up to date. Please come back soon to see the finished work! (1/05/2020)
Original Editors - Rachael Lowe
Top Contributors - Leana Louw, Admin, Kim Jackson, Daphne Jackson, Evan Thomas and WikiSysop
Description[edit | edit source]
Blount's disease, also known as tibia vara, is a growth disorder of the tibia (shin bone) that causes the lower leg to angle inward, resembling a bowleg.
Blount's disease occurs in young children and adolescents. The cause is unknown, but is thought to be due to the effects of weight on the growth plate. The inner part of the tibia, just below the knee, fails to develop normally, causing angulation of the bone. Unlike bowlegs, which tend to straighten as the child develops, Blount's disease is progressive and the condition worsens. It can cause severe bowing of the legs and can affect one or both legs.
This condition is more common among children of African ancestry. It is also associated with obesity, short stature, and early walking. There does not appear to be an obvious genetic factor.
Clinically Relevant Anatomy[edit | edit source]
add text here relating to clinically relevant anatomy of the condition
Etiology / Epidemiology[edit | edit source]
The cause of Blount's disease is assumed to be multifactoral, mostly mechanically due to childhood obesity.[1]
Mechanism of Injury / Pathological Process[edit | edit source]
Blount's disease is catagorised into early-onset if it develops in children under 4 years old, and late-onset, when it develops after the age of 4.[1]
Clinical Presentation[edit | edit source]
Multiplanar deformities of the lower leg includes:[1]
- Tibial varus
- Procurvatum
- Internal torsion
- Limb shortening
- Distal femoral varus (in late-onset)
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Medical management[edit | edit source]
Conservative management[edit | edit source]
Children who develop severe bowing before the age of 3 may be treated with bracing. However, bracing may fail, or bowing may not be detected until the child is older.
Surgical management[edit | edit source]
- Realignment tibial osteotomy: To be done before the age of 4 to decrease the risk of recurrent lower extremity deformity and to restore leg length where needed.[1]
- Distraction osteogenesis: For late-onset disease:[1]
- Aim to achieve multiplanar correction
- 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. This much smaller surgery is most effective in children with less severe bowing and significant growth remaining.[1]
Differential Diagnosis[edit | edit source]
add text here relating to the differential diagnosis of this condition
Resources[edit | edit source]
add appropriate resources here
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
