Blount's disease, Blount-Barber disease, nonrachitic bowlegs
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
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;
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
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.
What treatment involves initially in most cases, depending on age,
is having your child wear one or more braces on the legs.
be what is called a KAFO brace which stands for Knee-Ankle-Foot
Orethosis. 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.