Blount’s disease

Dr L Banza
7-9 Oct 2022
Progressive bow leg deformity associated with abnormal
growth of the posteromedial part of the proximal tibia.
Knee – Blount’s

Tibia Vara – Bow Legs

Bil in 80 %

More common:
• black > white
• Obese/ walk early
Cause unknown
• Increase stress on
medial growth plate
Blount’s

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- Deformity is worse than in physiological bowlegs

- May include internal rotation of the tibia

- There may be lateral subluxation of the tibia

 X Ray

- Proximal tibia epiphysis

flattened medially or
fragmented

- Metaphysis beak
shaped

- Medial cortex of the

Proximal tibia is
thickened
- Femoral epiphysis is
sometime affected

- Bony bar at later stage

preventing further
growth
The degree of proximal tibia vara can be quantified by measuring
the metaphyseo-diaphyseal angle ( Normal is < 11 degree ). One
line perpend to the axis of the tibia and another across the
metaphyseal flare.
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 Treatment

- Spontaneous resolution is rare

- Early and mild ( 1,2 ) : brace

Treatment
Later or more severe
Surgery ( addressing both varus and rotational components )
- Elevation of the medial tibial plateau may be required
- Excise a bony bar if present and replace it with a free fat
graft.
- Osteotomy
 Hemiepiphysiodesis

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 THANK YOU

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