Blount's Disease
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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]
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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]
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Outcome Measures[edit | edit source]
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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]
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Resources[edit | edit source]
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Case Studies[edit | edit source]
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References[edit | edit source]
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