231 results match your criteria Blount Disease


Osteotomy treatments and post-operative fixations for Blount disease: A systematic review.

Ann Med Surg (Lond) 2022 Jun 21;78:103784. Epub 2022 May 21.

Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-RSUD Dr. Saiful Anwar, Malang, East Java, Indonesia.

Background: Blount disease is a developmental abnormality characterized by abnormal ossification of proximal tibia, resulting in lower limb deformities with tibia vara. The condition worsens into knee deformity, gait abnormalities, and premature medial compartment osteoarthritis if left untreated. Managements of those deformities have also advanced in line with the understanding of the deformities. Read More

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Inversed V-shaped High Tibial Osteotomy for Severe Varus Deformity due to Blount Disease: A Case Report.

J Orthop Case Rep 2021 Sep;11(9):29-32

Department of Orthopaedic Surgery, Mazda Hospital, Fuchu, Hiroshima, Japan.

Introduction: Blount disease is a growth disorder of the medial proximal tibial physis causing a multi-planar deformity of the lower limb. Several types of surgical approaches have been described for the correction of angular deformity including external fixation, opened-/closed- wedge high tibial osteotomy (HTO), and tibial condylar valgus osteotomy. However, they are associated with various disadvantages such as limb length discrepancy, risk of infections, and delayed union at the osteotomy site, especially in cases of severe varus deformity. Read More

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September 2021

Guided Growth Procedures: Broken Tension Band Implants in Patients With Blount Disease.

J Pediatr Orthop 2022 May-Jun 01;42(5):e435-e440

Department of Orthopaedic Surgery and Sports Medicine, Shriners Hospital for Children Medical Center and University of Kentucky, Lexington KY.

Background: Tension band plate and screw implants (TBI) are frequently used for temporary hemiepiphyseodeses to manage angular deformity in growing children. The reported implant breakage rate, when TBI is used for deformities in patients with Blount disease, is much higher than when used in other diagnoses. Our hypothesis is that perioperative factors can identify risks for TBI breakage. Read More

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Comparative Evaluation of the Radiographic Parameters for Screening Early Blount Disease.

J Pediatr Orthop 2022 Apr;42(4):e343-e348

Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Radiographic findings in young children with physiological bowing sometimes difficult to distinguish from early Blount disease. However, early diagnosis of the disease is critical because of the poor treatment outcomes for Blount disease. In this study, we aim to evaluate the accuracy of the metaphyseal-diaphyseal angle (MDA) compared with the medial metaphyseal beak (MMB) angle for differentiating between physiological bowing and early Blount disease and to determine which parameter to adequately screen for the subsequent development of Blount disease. Read More

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Guided growth Tibial osteotomy at early stage of Blount disease in squelletically immature patients.

J Orthop 2021 May-Jun;25:140-144. Epub 2021 May 7.

Department of Pediatric Surgery, Lagune Mother and Child Teaching Hospital, Cotonou, Benin.

Background: There are no comparative study between guided growth and tibial osteotomy in early stage of Blount disease (BD) to our knowledge. The aim of this work was to compare the results of patients treated by these two techniques.

Method: This was a retrospective, descriptive, and analytical study over a period of 5 years in including 17 children (24 Knees) with an early stage of infantile BD in two centers. Read More

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Percutaneous hemiepiphysiodesis using transphyseal screws for adolescent tibia vara.

J Pediatr Orthop B 2022 Mar;31(2):127-133

Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, São Paulo.

Hemiepiphysiodesis around the knee is becoming the mainstay procedure in adolescents for a wide range of aetiological deformities, when considering adolescent tibia vara (ATV), the published series have variable results. The purpose of this study was to review our experience with the percutaneous transphyseal screw (PETS) in these patients followed until bone maturity. We analysed the charts from 13 patients (20 knees) that underwent lateral tibial hemiepiphysiodesis using PETS. Read More

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Blount Disease.

J Belg Soc Radiol 2021 23;105(1):51. Epub 2021 Sep 23.

"Reine Fabiola" Children's University Hospital, BE.

: MRI allows to assess deformity and viability of the tibia in Blount disease. Read More

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September 2021

Controlled Double Gradual Opening Osteotomy for the Treatment of Severe Varus of the Knee-Blount's Disease.

Arthrosc Tech 2021 Sep 28;10(9):e2199-e2206. Epub 2021 Aug 28.

Dysmetria and Deformities Center of National Institute of Traumatology and Orthopedics of Brazil, Rio de Janeiro, Brazil.

Varus deformity of the knee can lead to early degeneration of the medial tibiofemoral joint. Pediatric patients can be pathologically affected with this deformity known as Blount disease. The cause of this pathology is still uncertain, but some risk factors are well established, such as obesity and family history. Read More

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September 2021

Staged Bilateral Total Knee Arthroplasty for Neglected Blount Disease Using a Gap Balancing Technique.

Arthroplast Today 2021 Oct 13;11:25-31. Epub 2021 Aug 13.

Department of Orthopaedic Surgery, Rancho Los Amigos National Rehabilitation Center, Downey, CA.

Blount disease is an acquired, asymmetrical disorder of proximal tibial growth that results in a complex three-dimensional proximal tibial deformity, with tibial varus being the dominating feature. Although the exact pathophysiology is unknown, Blount disease is separated into 2 clinical variants, infantile and adolescent, based on the onset of symptoms occurring before or after the age of 10 years. If recognized and treated early, affected patients generally have a favorable prognosis; however, if neglected, it can lead to progressive malalignment and premature osteoarthritis. Read More

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October 2021

Infantile Blount disease: a developmental tibial growth defect.

Pan Afr Med J 2021 26;39:74. Epub 2021 May 26.

Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Sawangi Meghe, Wardha 442001, Maharashtra, India.

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September 2021

Acute correction of severe complex adolescent late-onset tibia vara by minimally invasive osteotomy and simple circular fixation: a case series with 2-year minimum follow-up.

BMC Musculoskelet Disord 2021 Aug 12;22(1):681. Epub 2021 Aug 12.

Present Address: Raigmore Hospital, Inverness, Scotland, UK.

Background: Despite multiple published reviews, the optimum method of correction and stabilisation of Blount's disease remains controversial. The purpose of this study is to evaluate the clinical and radiological outcomes of acute correction of late-onset tibial vara by percutaneous proximal tibial osteotomy with circular external fixation using two simple rings. Weighing up the pros and cons and to establish if this method would be the method of choice in similar severe cases especially in a context of limited resources. Read More

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Recurrence in infantile tibia vara (Blount disease) after high tibia and fibula osteotomy.

J Pediatr Orthop B 2022 Mar;31(2):134-138

Division of Orthopaedic Surgery, Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.

Infantile Tibia Vara (ITV or Blount disease) often recurs after surgical correction of the deformity. Vastly different recurrence rates have been reported in the literature. The main objective of this study was to identify any risk factors for the recurrence of ITV following high tibia and fibula valgus osteotomy. Read More

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Blount disease and familial inheritance in Ghana, area cross-sectional study.

BMJ Paediatr Open 2021 22;5(1):e001052. Epub 2021 Apr 22.

Orthopaedic Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.

Objective: The objective of this study is to study familial inheritance for Blount disease to create better understanding of the aetiology of Blount disease.

Methods: After reviewing patient files and conventional roentgenologic imaging, 139 patients with Blount disease were included in this cross-sectional study, of which 102 patients were interviewed. During the interviews, patient characteristics and family history were collected. Read More

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February 2022

Tibia vara in Asians: Myth or fact? Verification with three-dimensional computed tomography.

J Orthop Surg (Hong Kong) 2021 Jan-Apr;29(1):2309499021992618

National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Background: There is a common perception among surgeons that Asian tibiae are significantly more varus compared to non-Asians, contributed both by an acute medial tibial proximal angle (MPTA) and diaphyseal bowing. Insight into the normative morphology of the tibia allows generation of knowledge towards disease processes and subsequently planning for corrective surgeries.

Methods: Computed tomography (CT) scans of 100 normal adult knees, aged 18 years and above, were analysed using a 3-dimensional (3D) analysis software. Read More

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Langenskiöld classification of tibia vara: a multicenter study on interrater reliability.

J Pediatr Orthop B 2022 Mar;31(2):114-119

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Since 1952, when Langenskiöld introduced his six-stage classification on roentgenographic morphologies of tibia vara, this method has been used extensively in Orthopaedic studies. Different studies have tried to determine the reliability of this method. Although there are scarce reports of major variability in using Langenskiöld classification, but the question still remains, as to whether using expert subspecialists and MRI would improve its reliability. Read More

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The Medial Elevation Osteotomy for Late-presenting and Recurrent Infantile Blount Disease.

J Pediatr Orthop 2021 Feb;41(2):67-76

Department of Orthopaedic Surgery, School of Clinical Medicine, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.

Background: Late-presenting or recurrent infantile Blount disease (IBD) is characterized by knee instability because of medial tibial plateau depression, multiplanar proximal tibial deformity, and potential distal femoral deformity. The surgical treatment strategy includes medial elevation osteotomy to stabilize the knee, together with proximal tibial osteotomy to correct alignment, and lateral epiphysiodesis to prevent a recurrence. This study's primary aim was to describe the clinical outcomes of medial elevation osteotomy for the management of late-presenting and recurrent IBD. Read More

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February 2021

Predictive Factors for Recurrence in Infantile Blount Disease Treated With Tibial Osteotomy.

J Pediatr Orthop 2021 Jan;41(1):e36-e43

Department of Orthopaedic Surgery, School of Clinical Medicine, University of KwaZulu-Natal, Msunduzi, South Africa.

Background: This study aimed to determine the recurrence rate in infantile Blount disease (IBD) in a cohort of patients treated with a tibial osteotomy; and also to identify which factors were associated with recurrence.

Methods: We reviewed the records of 20 patients, under the age of 7 years, with IBD (35 involved extremities) treated by proximal tibial realignment osteotomy to physiological valgus at a single institution over 4 years. We then analyzed the data to determine the rate of recurrence and identify the risk factors for recurrence. Read More

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January 2021

Infantile Tibia Vara (Blount Disease) with Iatrogenic Changes Causing Residual Tibial Deformities.

J Surg Orthop Adv 2020 ;29(3):141-148

Department of Orthopaedic Surgery, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware.

Treatment of infantile tibia vara or Blount disease (ITV/BD) in patients < 3 years old and Langenskiold stages I-III consists of orthosis and, in relapsing cases, proximal tibial osteotomy and/or proximal tibial guided growth laterally with a tension band plate. Our aim was to evaluate the results of treatments in a consecutive group. After Institutional Review Board approval, data from 2002 to 2018 were collected. Read More

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November 2020

Medial Metaphyseal Beak Angle as a Predictor for Langenskiöld Stage II of Blount's Disease.

Orthop Surg 2020 Dec 30;12(6):1703-1709. Epub 2020 Sep 30.

Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To determine the medial metaphyseal beak (MMB) cut-off angle predicting Langenskiöld stage II of Blount's disease and to study the intra-observer and inter-observer reliabilities of angle measurements and the influence of the experience level of observers.

Methods: A retrospective study was conducted on children aged 2-4 years from January 2000 to December 2017. Children were identified through a computer-based search. Read More

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December 2020

Predictors of early recurrence following high tibial osteotomy for infantile tibia vara.

Int Orthop 2021 05 16;45(5):1233-1238. Epub 2020 Sep 16.

Department of Orthopaedic Surgery, University of Cape Town, Cape Town, South Africa.

Aims: Recurrence of deformity following high tibial osteotomy (HTO) for infantile tibia vara (ITV) is common. The purpose of this study was to identify risk factors for recurrent deformity following HTO for ITV and to develop a simple scoring system to quantify the risk of recurrence in each patient.

Patients And Methods: We identified 69 patients with 102 affected limbs undergoing HTO for ITV from 2005 to 2015. Read More

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Guided Growth with Hemiplateau Elevation as an Alternative to Epiphysiodesis for Treatment of a Young Patient with Advanced Infantile Blount Disease: A Case Report.

JBJS Case Connect 2020 Jul-Sep;10(3):e1900643

1Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo Michigan 2Department of Orthopaedic Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo Michigan 3Department of Biomedical Science, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo Michigan.

Case: Infantile Blount disease results from deceleration of growth by the proximal posteromedial tibial physis causing tibia vara. In advanced disease stages, surgical treatment is indicated. Owing to the young age and advanced Langenskiöld stage in this patient, a novel technique was performed combining lateral proximal physeal tethering with medial hemiplateau elevation osteotomy to correct the articular surface and unload the medial proximal tibial physis. Read More

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The efficacy of guided growth as an initial strategy for Blount disease treatment.

J Child Orthop 2020 Aug;14(4):312-317

The Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.

Purpose: The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease.

Methods: This was a retrospective multicentre study conducted in five centres, covering data on 55 limbs in 45 patients, with an average follow-up of 24.5 months following plate insertion. Read More

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Ipsilateral Osteochondritis Dissecans-like Distal Femoral Lesions in Children with Blount Disease: Prevalence and Associated Findings.

Strategies Trauma Limb Reconstr 2019 Sep-Dec;14(3):121-125

Department of Orthopedic Surgery, University of California, San Francisco, USA; UCSF Benioff Children's Hospital, Oakland, California, USA.

Purpose: Our goal was to assess the prevalence of ipsilateral distal femoral osteochondritis dissecans (OCD)-like lesions in children with Blount disease, including factors associated with this finding.

Materials And Methods: Characteristics of patients with an OCD-like lesion on an imaging study [(X-ray and/or magnetic resonance imaging (MRI)] were compared with those without such a finding.

Results: Over a 12-year period, 6/63 (10%) skeletally immature patients (9/87 limbs) with Blount disease had an OCD-like lesion visible on plain radiographs. Read More

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Blount's disease - an up-to-date insight with contemporary treatment guidelines deduced from critical analysis of a large 146 surgical case series.

J Pediatr Orthop B 2021 May;30(3):239-249

Department of Orthopaedic Surgery, Damanhour Medical National Institute, Damanhour, Egypt.

To elucidate an up-to-date insight and derive clear treatment guidelines for Blount's disease deduced from critical analysis of 146 surgical case series. Cases were presented and analyzed separately under its two basic clinical groups and the author further derived four subcategories under each of these two groups; the first basic group was the early onset clinical variant; infantile tibia vara (ITV) included 56 cases. The second group was the late onset clinical variant; late onset tibia vara (LOTV) included 90 cases. Read More

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Double Level Osteotomy Assisted by 3D Printing Technology in a Patient with Blount Disease: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e0477

Department of Orthopedic Surgery and Traumatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain.

Case: We describe the case of a 26-year-old patient diagnosed with Blount disease. She underwent a medial oblique supracondylar biplanar closing-wedge osteotomy of the distal femur followed by a medial oblique biplanar opening-wedge osteotomy of the proximal tibia. 3D printed cutting guides were used for the procedures. Read More

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February 2021

The femoral deformity in Blount's disease: a comparative study of infantile, juvenile and adolescent Blount's disease.

J Pediatr Orthop B 2020 Jul;29(4):317-322

Department of Orthopaedic Surgery, Faculty of Health Science, University of the Witwatersrand.

An associated femoral deformity in patients with Blount's disease is not commonly described in the literature. The objective of this study is to establish the presence and magnitude of deformity in the coronal plane of the distal femur in children of all ages with Blount's disease and compare this to a matched cohort of children from the same population. This was a retrospective review of patients from an academic hospital. Read More

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Blount Disease and Obstructive Sleep Apnea: An Under-recognized Association?

J Pediatr Orthop 2020 Nov/Dec;40(10):604-607

Departments of Orthopedic Surgery.

Background: Obesity is strongly associated with both Blount disease and obstructive sleep apnea (OSA). Obesity increases risks for anesthetic and postoperative complications, and OSA can further exacerbate these risks. Since children with Blount disease might have both conditions, we sought to determine the perioperative complications and the prevalence of OSA among these children. Read More

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Do Different Tibial Osteotomy Techniques Affect Sagittal Alignment in Children with Blount Disease?

Orthop Surg 2020 Jun 16;12(3):770-775. Epub 2020 Apr 16.

Department of Biochemistry,, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To determine the radiographic outcomes following dome or wedge-shaped proximal tibial osteotomy in the management of infantile Blount disease with a particular interest in sagittal alignment of the knee joint.

Method: Medical records of patients with Langenskiöld stage 2 Blount disease (aged ≤5 years) who underwent surgical correction between January 2005 and November 2019 were retrospectively identified. Patients with metabolic bone disease, bone tumors, prior traumatic fractures, congenital anomalies, inadequate plain films, and incomplete medical documents were excluded. Read More

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Aetiology of nutritional rickets in rural Bangladeshi children.

Bone 2020 07 7;136:115357. Epub 2020 Apr 7.

MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.

Objectives: A high prevalence of rickets of unknown aetiology has been reported in Chakaria, Bangladesh. Classically, rickets is caused by vitamin D deficiency but increasing evidence from Africa and Asia points towards other nutritional deficiencies or excessive exposure to some metals. The aim of this study was to investigate the aetiology of rickets in rural Bangladeshi children. Read More

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