BLOUNT DISEASE

1. 861
2. 9170
3. VASILIA
4. (cdk jurnal)
5. ADMIN
6. birch
7. INFANTILE
8. statpearl

CVET

1. CDK
2. 3018

The clinical features of established infantile Blount disease include a variable amount of varus deformity
of the proximal tibia, increased internal tibial torsion, a palpable prominence or “beaking” of the
proximal medial tibial epiphysis and metaphysis and, in unilateral cases, leg length inequality. Despite
the frequent radiographic appearance of flexion deformity, this is not often evident clinically. Typically,
the patient presents with no tenderness, knee effusion, or restriction of joint motion, although
deformity-accentuating varus instability may be present. Approximately 50% of patients present with
bilateral deformity that is not necessarily symmetric. A characteristic lateral thrust may be noted in the
child’s gait and, with single limb stance, the varus deformity acutely accentuates as if the knee were
unstable. In addition to varus deformity, the amount of physeal and epiphyseal distortion varies (Figure
1). Typically, the femur is normal, although compensatory distal femoral valgus deformity may be
present in advanced persistent cases.

Patients with adolescent Blount disease are frequently obese and typically present with progressive
varus deformity of the leg with or without vague knee pain. The disorder may be unilateral, bilateral, or
asymmetric. In asymmetric and unilateral cases, the surgeon must evaluate for the presence and
severity of leg length inequality. Radiographic findings typically include varus deformity and widening or
lucency of the medial tibial physis, the so called zone of injury. Often, concomitant radiographic
evidence of distal femoral physeal growth disturbance and/or varus deformity exists, contributing to the
overall severity of varus deformity. Similar to infantile Blount disease, patients with the adolescent form
of the disease have variable internal tibial torsion and proximal tibial flexion (procurvatum) deformities.
In some patients, distal tibial valgus deformity is present.