Blount's disease: classification and treatment.
Forty-three tibia vara in 27 patients were analyzed retrospectively in two centers. The criteria for diagnosis of the child form are discussed. A simple classification is suggested to facilitate the choice of treatment. In stage 0 (possible Blount's disease), the patient is younger than 2 1/2 years, and an observation period is indicated for gathering data. In stage 1 (confirmed Blount's disease and absence of medial metaphyseal bony bridge), known as physis+, a valgization osteotomy is proposed. In stage 2 (evidence of a medial metaphysoepiphyseal bony bridge) known as physis-, valgization osteotomy with lateral epiphysiodesis and treatment of the lower limb discrepancy is proposed. For stages 1 and 2, there are two possibilities: normal medial tibial plateau or sloping of the medial tibial plateau, indicating a transphyseal elevation osteotomy. When one-step correction is proposed for stage 2 disorder, external fixators such as Orthofix or Ilizarov devices are useful.
Laville
J M
JM
C. H. D. F. Guyon, Saint-Denis, La Reunion, Lyon, France.
Chau
E
E
Willemen
L
L
Kohler
R
R
Garin
C
C
D000293:Adolescent; D000328:Adult; D001848:Bone Diseases, Developmental / Q000145:classification* / Q000150:complications / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D007870:Leg Length Inequality / Q000209:etiology / Q000628:therapy; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D009989:Orthotic Devices; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D013977:Tibia / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome