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    Blounts Disease

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    chinmayghaisas
    This document discusses Blount's disease, which is a condition that affects the growth plate of the tibia and causes bowing of the leg. It presents in two forms - infantile and adolescent. The infantile type affects younger, obese black females and causes bilateral bowing without pain. The adolescent type causes unilateral bowing and pain in overweight teens. Diagnosis is made based on x-ray findings and staging systems. Treatment depends on the stage but may include bracing, osteotomies, epiphysiodesis, or realignment procedures to correct the bowing deformity.

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    Blounts Disease

    Uploaded by

    chinmayghaisas
    107 views27 pages
    This document discusses Blount's disease, which is a condition that affects the growth plate of the tibia and causes bowing of the leg. It presents in two forms - infantile and adolescent. The infantile type affects younger, obese black females and causes bilateral bowing without pain. The adolescent type causes unilateral bowing and pain in overweight teens. Diagnosis is made based on x-ray findings and staging systems. Treatment depends on the stage but may include bracing, osteotomies, epiphysiodesis, or realignment procedures to correct the bowing deformity.

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    This document discusses Blount's disease, which is a condition that affects the growth plate of the tibia and causes bowing of the leg. It presents in two forms - infantile and adolescent. The infantile type affects younger, obese black females and causes bilateral bowing without pain. The adolescent type causes unilateral bowing and pain in overweight teens. Diagnosis is made based on x-ray findings and staging systems. Treatment depends on the stage but may include bracing, osteotomies, epiphysiodesis, or realignment procedures to correct the bowing deformity.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    107 views27 pages

    Blounts Disease

    Uploaded by

    chinmayghaisas
    This document discusses Blount's disease, which is a condition that affects the growth plate of the tibia and causes bowing of the leg. It presents in two forms - infantile and adolescent. The infantile type affects younger, obese black females and causes bilateral bowing without pain. The adolescent type causes unilateral bowing and pain in overweight teens. Diagnosis is made based on x-ray findings and staging systems. Treatment depends on the stage but may include bracing, osteotomies, epiphysiodesis, or realignment procedures to correct the bowing deformity.

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    BLOUNTS

    DISEASE
    Moderators:Dr.K.G
    Kamath
    Dr.Ronald M
    Presenter:Dr.Gururaj
    Date:30/06/09

    History
    Erlacher

    reported the first case of tibia vara

    in 1922.

    1937, Blount reported 13 more cases and

    reviewed all of the 15 cases that were


    reported in the literature up to that time.
    Blount suggested the term tibia vara.

    Normal Tibio -femoral


    angles

    Physiological genu
    varum

    In utero molding of
    the lower
    extremities

    Definition
    Disease of unknown etiology that affects the

    metaphysis,,the growth plate and the


    epiphysis of the posteromedial aspect of
    proximal tibia resulting in a varus and internal
    rotation deformity(Blount and Milwakee 1937)

    Etiology
    Exact cause unknown
    Combination of hereditory and developmental

    factors
    Abnormal stress placed on the posteromedial

    proximal tibial epiphysis that leads to growth


    suppression

    Obese pt (body weight)


    Abnormal stress
    Static varus knee
    Compr ession of medial
    lateral
    physis

    tensile strsses on
    physis

    progressive genu varum

    pathology
    1)densely packed cartilage cells displaying
    hypertrophy
    2)islands of acellular cartilage
    3)large clusters of vessels
    Disrupted enchondral ossification.

    Age
    The infantile ( 1-3 years)
    juvenile (4-10 years)
    adolescent(11-14 years)

    Clinical features
    Infantile tibia vara

    -females
    - blacks
    -marked
    obesity
    -no pain

    -palpable metaphyseal beak


    -leg length descrepancy
    -lateral thrust to the knee during the stance
    phase of gate
    -bilateral in approximately 80%

    Adolesent tibia vara


    complain of pain
    typically overweight

    or obese
    unilateral in 80% of
    cases

    Radiological features
    Langenskiold staging

    Metapyseal diaphyseal angle

    Levine and drennan angle


    >11 degrees risk of

    blounts disease is high


    >16 degrees diagnostic

    Infantile tibia vara


    Widened irregular

    physeal line
    Increased meta-diap
    angle >11 degrees
    Sloped irregularly
    occupied epiphysis
    Metaphyseal beak

    Adolescent tibia vara

    Slope relatively

    normal
    Lack of meta beak
    Widened medial
    physeal plate

    Differential diagnosis
    Physiological genu varum

    -gradual curve involving both tibia and


    femur.
    -non progressive, spontaneously resolves.
    Hypophosphatemic rickets
    -short stature and genu varum
    -x rays rachitic changes in physis
    -s.phospharus is low
    Metaphyseal chondrodysplasia
    Congenital bowing

    Treatment
    Langenskiold stage 1 and 2

    <3 yrs: orthotics


    >3 yrs: corrective osteotomy

    Langenskiold stage3: corrective osteotomy,

    delay in surgery after 4 yrs more chances of


    recurrence.

    Langenskiold stage4 and 5: physiologic

    physeal arrest

    In pt younger than 8 years or with 2 yrs


    skeletal growth remaining Realignment and
    medial physeal resection with placement of
    interpositioning material .

    Langenskiold stage6: established bony bridge


    if pt has < 2 yrs growth remaining and normal

    joint surface
    corrective osteotomy with complete
    physeal closure
    If > 2 yrs of growth is remaining ,
    resection of bony bridge (asymmetrical
    physeal distraction)with replacement of
    interposition graft

    incongruity of joint surface - intraarticular

    directed ostetomy

    adolescent tibia vara:

    - corrective osteotomy
    - lateral epiphysiodesis
    -realignment by external fixation.

    Orthotics

    KAFO

    ELASIC BLOUNT BRACES.


    Can be used 23 hrs a day,

    or partial time wear (only


    during nights ) both are
    equally successful

    osteotomy
    Distal to the tibial tubercle.
    internal tibial torsion corrected by external

    rotation of tibial component .


    fibular osteotomy should be performed

    through separate incision.

    Rabs osteotomy

    Greene chevron
    osteotomy

    Epiphyseal and metaphyseal osteotomy


    Intra epiphyseal osteotomy
    Hemi elevation of epiphysis and osteotomy

    with leg lengthening using ilizarao

    Thank
    you

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