Infantile Blount's Disease Research Articles

Physiological bowlegs or infantile Blount's disease. Some new aspects on an old problem.

The differentiation between physiological bowlegs and infantile Blount's disease in patients aged 11-30 months is very difficult. Nevertheless, diagnosis is deemed important because treatment of infantile Blount's disease is recommended. Fourteen patients with severe bowing of the legs seen in our outpatient clinic were investigated retrospectively. We examined them and measured the tibiofemoral and metaphyseal/diaphyseal angles in radiographs taken at their first presentation. The finding that the tibiofemoral angle is not helpful in differential diagnosis could be confirmed but, contrary to reports by other authors, neither was the metaphyseal/diaphyseal angle. In view of the spontaneous recovery of all investigated patients, it must be doubted whether a diagnosis of infantile tibia vara can be made in early infancy, and whether infantile Blount's disease is a diagnosis in its own right.

Double-Elevating Osteotomy of Tibiae in the Treatment of Severe Cases of Blountʼs Disease

The results of operative correction of 13 cases of tibia vara in 10 children with advanced infantile Blount's disease are presented. All of the children were operated by "double-elevating" osteotomy. An essential element of this procedure was the reconstruction of the horizontal level of the medial tibial plateau. The average follow-up after treatment was 8 years 1 month. We recommend this method of osteotomy in cases of considerable depression of the medial tibial condyle with the defect of epiphyseal bone and as a bone bridge between the metaphysis and the epiphysis.

Blountʼs disease after skeletal maturity.

Twelve patients, seventeen to twenty-five years old, who had had infantile Blount's disease involving nineteen limbs, were evaluated at a mean of twelve years after an initial osteotomy. Twelve of the nineteen knees were symptomatic, and eight of the symptomatic knees showed early degenerative changes by arthroscopy or arthrotomy. There was a direct correlation between the symptoms and the severity of the involvement of the proximal end of the tibia. A poor final outcome appears to be related to physeal damage. Early osteotomy must be performed before permanent physeal damage and subsequent incongruity of the joint occur.