Blount’s disease

  • Blount’s disease is a growth disorder of the tibia characterised by bowing of legs
  • Also called pathologic tibia vara, non rachitic bowlegs, Blount Barber disease
  • Clinical features
    • Presents with progressive bowing of legs in a child
    • There is varus angulation and internal rotation of tibia
    • Usually seen in children if African origin
    • Associated with obesity, early walking and short stature
  • Clinical types
    • Infantile – early onset (<3 years of age)
    • Juvenile – 4-10 years
    • Adolescent – >11 years
  • Pathology
    • There is disordered bone ossification in the medial part of proximal tibial epiphysis, physis and metaphysis
    • Presumed to be caused by excessive compressional forces on the proximal medial tibial epihysis and alteration in bone formation
    • Weight bearing is necessary for development of Blount’s disease as it is not seen in non ambulatory individuals
  • Differential diagnosis
    • Physiological bowing – in contrast with blount’s disease which has a acute angulation in the proximal tibia, physiological bowing is characterised by smooth angulation of femur and tibia
    • Congenital bowing
    • Rickets – Other features of rickets will be present, responds to treatment with Vitamin D
    • Ollier’s disease – Radiographs will reveal presence of multiple enchondromas
    • Trauma, osteomyelitis – can damage the growth plate and defects similar to blount’s disease
  • Treatment
    • Braces are worn to correct the deformity (usually Knee Ankle Foot Orthosis – KAFO)
    • If deformity is not corrected even after wearing braces for 12 months, corrective surgery can be done

Obesity in childhood and adolescence By Wieland Kiess, Claude Marcus, Martin Wabitsch

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KAFO – Acronym

KAFO stands for : Knee Ankle Foot Orthosis (used in orthopedics)