Blount's Disease


Definition
Blount's disease, Blount-Barber disease, nonrachitic bowlegs in children.
 
Radiographic Appearance
 Physiologic bowing typically show flaring and bowing of tibia and femur in a symmetric fashion
and is normal in children < 2 years of age (maximal at about 18 mo);
- physiologic genu valgum, or knock knees, develops next, w/ maximal deformity
occurring at 3 years of age;
- gradual correction to ultimate alignment of slight genu valgum occurs by 9 years
of age in the great majority of patients;

 
Pathology
Blount's Disease is one which affects the bone development of toddlers and older children. Most often, it starts as bow-leggedness which does not improve in a child between two and four years of age. Seeking appropriate treatment in a timely matter can help your child develop normally.
Bow-leggedness in toddlers is particularly common most especially in those who walk at an early age and those who are slightly overweight for their age and height. But legs that are bowed and which do not correct by age two are cause for concern and investigation to see if Blount's Disease is a possibility.
What happens with Blount's Disease is that as the child grows and the legs are bowed, some children have the tendency, for unknown reasons, to develop bones which continue to bow. It is a vicious circle. The bow-leggedness causes further bow-leggedness which perpetuates the problem.
So as the legs continue to grow abnormally the child is forced to walk with knees that bulge outward and continue to get worse. What often accompanies this is a condition called internal tibial torsion. What this is, is toes which turn inward below the knee. The toes point obviously inward and some children even have a tendency to fall down more often with this infliction. When bow-leggedness and tibial torsion occur together it is a red flag g that it is probably Blount's Disease.
 
Treatment:
What treatment involves initially in most cases, depending on age, is having your child wear one or more braces on the legs. They would be what is called a KAFP brace which stands for Knee-Ankle-Foot Prosthetic. The brace begins at the top of the thigh and extends to the tip of the toes, following underneath the foot. There are a variety of styles but the goal is the same -- to correct the abnormal development in the knee and hopefully straighten the leg.

Once a brace has been designed for your child which involves making a cast of the leg and fitting it to your youngster, there will be follow-up exams and ongoing x-rays to follow the progress and be sure the brace is working effectively. If it does not do its job over a period up to 12 months or more, then corrective surgery is an option. Obviously, this is not the preferred option but it can occur, particularly if Blount's Disease is not caught early on.
 
Image 1 Blount's Disease

 

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