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What Is the Best Treatment for Blount’s Disease?

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Paediatric Orthopaedics

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Abstract

Bowed legs are a common appearance in children. Physiologic bowing is distinct from infantile Blounts and adolescent tibia vara, both of which are likely mechanical phenomena resulting from obesity, but have separate findings and treatment algorithms. Infantile Blounts is suspected with progressive or asymmetrical bowing with a lateral thrust during ambulation. Once confirmed with radiographs demonstrating a beaked medial proximal tibial metaphysis, treatment is initiated with bracing and/or surgical correction. Adolescent, or late-onset tibia vara, is almost always treated surgically. Treatment is aimed at both restoring knee joint line orientation and overall mechanical axis of the lower extremities with equal limb lengths.

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References

  1. Levine AM, Drennan JC. Physiological bowing and tibia vara. The metaphyseal-diaphyseal angle in the measurement of bowleg deformities. J Bone Joint Surg Am. 1982;64(8):1158–63.

    Article  CAS  PubMed  Google Scholar 

  2. Davids JR, Blackhurst DW, Allen Jr BL. Radiographic evaluation of bowed legs in children. J Pediatr Orthop. 2001;21(2):257–63.

    Google Scholar 

  3. Blount W. Tibia vara. Osteochondrosis deformans tibiae. J Bone Joint Surg. 1937;19(1):1–29.

    Google Scholar 

  4. Herring JA, editor. Tachdjians, pediatric orthopaedics, vol. 1. Philadelphia: Saunders Elsevier; 2008.

    Google Scholar 

  5. Montgomery CO et al. Increased risk of Blount disease in obese children and adolescents with vitamin D deficiency. J Pediatr Orthop. 2010;30(8):879–82.

    Article  PubMed  Google Scholar 

  6. Aird JJ, Hogg A, Rollinson P. Femoral torsion in patients with Blount’s disease: a previously unrecognised component. J Bone Joint Surg. 2009;91-B(10):1388–93.

    Article  Google Scholar 

  7. Langenskiold A. Tibia vara; (osteochondrosis deformans tibiae); a survey of 23 cases. Acta Chir Scand. 1952;103(1):1–22.

    CAS  PubMed  Google Scholar 

  8. Raney EM et al. Orthotic treatment of infantile tibia vara. J Pediatr Orthop. 1998;18(5):670–4.

    Article  CAS  PubMed  Google Scholar 

  9. Richards BS, Katz DE, Sims JB. Effectiveness of brace treatment in early infantile Blount’s disease. J Pediatr Orthop. 1998;18(3):374–80.

    CAS  PubMed  Google Scholar 

  10. Scott AC. Treatment of infantile blount disease with lateral tension band plating. J Pediatr Orthop. 2012;32(1):29–34.

    Article  PubMed  Google Scholar 

  11. Wiemann JM, Tryon C, Szalay EA. Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee. J Pediatr Orthop. 2009;29(5):481–5.

    Article  PubMed  Google Scholar 

  12. Andrade N, Johnston CE. Medial epiphysiolysis in severe infantile tibia vara. J Pediatr Orthop. 2006;26(5):652–8.

    Article  PubMed  Google Scholar 

  13. Sabharwal S et al. Intra-articular morphology of the knee joint in children with Blount disease. J Bone Joint Surg (Am). 2013;94(10):883–90.

    Google Scholar 

  14. Montgomery CO et al. Increased risk of blount disease in obese children and adolescents with vitamin D deficiency. J Pediatr Orthop. 2010;30(8):879–82.

    Article  PubMed  Google Scholar 

  15. Gordon JE. Obstructive sleep apnoea syndrome in morbidly obese children with tibia vara. J Bone Joint Surg. 2006;88-B(1):100–3.

    Article  Google Scholar 

  16. Myers TG et al. Incidence of distal femoral and distal ibial deformities in infantile and adolescent blount disease. J Pediatr Orthop. 2005;25(2):215–8.

    Article  PubMed  Google Scholar 

  17. Paley D,Tetsworth K. Mechanical axis deviation of the lower limbs. Clin Orthop Relat Res. 1992;&NA;(280):48???64.

    Google Scholar 

  18. Feldman DS et al. Accuracy of correction of tibia vara. J Pediatr Orthop. 2006;26(6):794–8.

    Article  PubMed  Google Scholar 

  19. Gilbody J, Thomas G, Ho K. Acute versus gradual correction of idiopathic tibia vara in children. J Pediatr Orthop. 2009;29(2):110–4.

    Article  PubMed  Google Scholar 

  20. Clarke SE, McCarthy JJ, Davidson RS. Treatment of blount disease. J Pediatr Orthop. 2009;29(2):103–9.

    Article  PubMed  Google Scholar 

  21. Sachs O et al. Treatment of adolescent blount disease using Taylor spatial frame with and without fibular osteotomy. J Pediatr Orthop. 2014;35(5):501–6.

    Article  Google Scholar 

  22. Li Y, Spencer SA, Hedequist D. Proximal tibial osteotomy and taylor spatial frame application for correction of tibia vara in morbidly obese adolescents. J Pediatr Orthop. 2013;33(3):276–81.

    Article  PubMed  Google Scholar 

  23. Feldman DS et al. Correction of tibia vara with six-axis deformity analysis and the Taylor spatial frame. J Pediatr Orthop. 2003;23(3):387–91.

    PubMed  Google Scholar 

  24. Park S-S. Outcome of hemiepiphyseal stapling for late-onset tibia vara. J Bone Joint Surg (Am). 2005;87(10):2259.

    Google Scholar 

  25. McIntosh AL. Treatment of adolescent tibia vara with hemiepiphysiodesis: risk factors for failure. J Bone Joint Surg (Am). 2009;91(12):2873.

    Article  Google Scholar 

  26. Sabharwal S et al. Do children with blount disease have lower body mass index after lower limb realignment? J Pediatr Orthop. 2013;34(2):213–8.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Connecticut Children’s Medical Center, Hartford, Connecticut, USA

    Sonia Chaudhry

  2. Queen Elizabeth Hospital, Gateshead, UK

    Paul A. Banaszkiewicz

Authors
  1. Sonia Chaudhry
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  2. Paul A. Banaszkiewicz
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Corresponding author

Correspondence to Sonia Chaudhry .

Editor information

Editors and Affiliations

  1. Royal Manchester Children’s Hospital, Manchester, United Kingdom

    Sattar Alshryda

  2. Sidra Medical and Research Center, Doha, Qatar

    James S. Huntley

  3. Queen Elizabeth Hospital, Gateshead, United Kingdom

    Paul A. Banaszkiewicz

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Chaudhry, S., Banaszkiewicz, P.A. (2017). What Is the Best Treatment for Blount’s Disease?. In: Alshryda, S., Huntley, J., Banaszkiewicz, P. (eds) Paediatric Orthopaedics. Springer, Cham. https://doi.org/10.1007/978-3-319-41142-2_14

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  • DOI: https://doi.org/10.1007/978-3-319-41142-2_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41140-8

  • Online ISBN: 978-3-319-41142-2

  • eBook Packages: MedicineMedicine (R0)

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