Can Blount's disease heal spontaneously?
BACKGROUND
In stage 1 of all currently accepted classifications for infantile tibia vara, the diagnosis is difficult between physiological bowing and true Blount's disease. There is no evidence of prognosis criteria for surgical treatment at this stage.


METHODS
We retrospectively studied a series of 26 patients born in the Indian Ocean area, presenting at stage 1 of the disease, in order to determine whether any of them were likely to heal without treatment.


RESULTS
It was found that children seen at stage 1 of infantile tibia vara have a one-in-three chance of healing spontaneously.


CONCLUSIONS
An alternative classification in three stages could then provide more suitable therapeutic indications: stage 0: possible Blount's disease (patient older than 2.5 years); stage 1: certain Blount's disease, active physis (+) (progressive varus, age >3 years, typical image with no epiphysiodesis bridging); stage 2: certain Blount's disease, inactive physis (-) (superomedial tibial bony bridge).


METHODS
Level IV. Retrospective study.
Laville
J-M
JM
Pediatric Surgery Unit, Reunion Regional Hospital Center, 97405 Saint-Denis, Reunion. lavillejm@wanadoo.fr
Wiart
Y
Y
Salmeron
F
F
D000293:Adolescent; D001848:Bone Diseases, Developmental / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007195:Indian Ocean Islands; D007223:Infant; D008297:Male; D055034:Osteochondrosis / Q000145:classification / Q000151:congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011379:Prognosis; D011859:Radiography; D012075:Remission, Spontaneous; D012189:Retrospective Studies