Blount's disease

{{Empty section|date=February 2023}}

Blount disease is a growth disorder of the shin bone which causes the lower leg to angle inward, resembling a bowleg. It can present in boys under 4-years in both legs, or in adolescents usually on one side. Causes are thought to be genetic and environmental, like obesity, African-American lineage, and early walkers.Dakshina Murthy T S. S; Alessandro De Leucio. [https://www.ncbi.nlm.nih.gov/books/NBK560923/ Blount Disease] {{Webarchive|url=https://web.archive.org/web/20240531134827/https://www.ncbi.nlm.nih.gov/books/NBK560923/ |date=2024-05-31 }} Treasure Island (FL): StatPearls Publishing; 2022 January.

Lower extremity deformities in rickets can closely mimic those produced by Blount's disease. To differentiate between rickets and Blount's disease it is important to correlate the clinical picture with laboratory findings such as calcium, phosphorus and alkaline phosphatase. Besides the X-ray appearance. Bone deformities in rickets have a reasonable likelihood to correct over time, while this is not the case with Blount's disease.{{citation needed|date=March 2024}} Nevertheless, both disorders may need surgical intervention in the form of bone osteotomy or more commonly guided growth surgery.{{cite journal|last1= EL-Sobky|first1=TA|last2=Samir|first2=S|last3=Baraka|first3=MM|last4=Fayyad|first4=TA|last5=Mahran|first5=MA|last6=Aly|first6=AS|last7= Amen|first7=J|last8= Mahmoud|first8=S| title= Growth modulation for knee coronal plane deformities in children with nutritional rickets: A prospective series with treatment algorithm.|journal= JAAOS: Global Research and Reviews|date=1 January 2020|volume=4|issue=1|pages=e19.00009|doi=10.5435/JAAOSGlobal-D-19-00009|pmid=32159063|pmc=7028784|doi-access=free}} Osteochondrodysplasias or genetic bone diseases can cause lower extremity deformities similar to Blount's disease. The clinical appearance and the characteristic radiographic are important to confirm the diagnosis.{{cite journal|last1=EL-Sobky|first1=TA|last2=Shawky|first2=RM|last3=Sakr|first3=HM|last4=Elsayed|first4=SM|last5=Elsayed|first5=NS|last6=Ragheb|first6=SG|last7=Gamal|first7=R|s2cid=79825711|title=A systematized approach to radiographic assessment of commonly seen genetic bone diseases in children: A pictorial review.|journal= J Musculoskelet Surg Res|volume=1|issue=2|pages=25|date=15 November 2017|doi=10.4103/jmsr.jmsr_28_17 |doi-access= free}}{{Cite book|last1=Solomon|first1=Louis|url=http://www.hodderarnold.com|title=Appley's System of Orthopaedics and Fractures|last2=Warwick|first2=David|last3=Nayagam|first3=Selvadurai|publisher=Hodder Arnold|year=2010|isbn=978-0-340-942-086|edition=9th|location=London|pages=556–557}}{{Dead link|date=October 2023 |bot=InternetArchiveBot |fix-attempted=yes }}File:Staples for epiphysiodesis, Blount's disease - rtg. and experiments.png

Children who develop severe bowing before the age of 3 may be treated with knee ankle foot orthoses.{{Cite journal | pmid = 23344116| year = 2013| last1 = Alsancak| first1 = S| title = Orthotic variations in the management of infantile tibia vara and the results of treatment| journal = Prosthetics and Orthotics International| volume = 37| issue = 5| pages = 375–83| last2 = Guner| first2 = S| last3 = Kinik| first3 = H| s2cid = 24907234| doi = 10.1177/0309364612471369}} However, bracing may fail, or bowing may not be detected until the child is older. Bracing should be started by 3 years of age. In some cases, surgery may be performed.{{cite journal |vauthors=McCarthy JJ, MacIntyre NR, Hooks B, Davidson RS |s2cid=21625248 |title=Double osteotomy for the treatment of severe Blount disease |journal=J Pediatr Orthop |volume=29 |issue=2 |pages=115–9 |date=March 2009 |pmid=19352234 |doi=10.1097/BPO.0b013e3181982512 }}{{Cite journal |last1=Frydrýšek |first1=Karel |last2=Čepica |first2=Daniel |last3=Halo |first3=Tomáš |last4=Skoupý |first4=Ondřej |last5=Pleva |first5=Leopold |last6=Madeja |first6=Roman |last7=Pometlová |first7=Jana |last8=Losertová |first8=Monika |last9=Koutecký |first9=Jan |last10=Michal |first10=Pavel |last11=Havlas |first11=Vojtěch |date=January 2022 |title=Biomechanical Analysis of Staples for Epiphysiodesis |journal=Applied Sciences |language=en |volume=12 |issue=2 |pages=614 |doi=10.3390/app12020614 |issn=2076-3417|doi-access=free |hdl=10084/146236 |hdl-access=free }}

Blount disease is one of the 8 severe comorbidities of severe obesity (BMI >35), which are an indication for bariatric surgery in children per a 2019 policy statement of the American Academy of Pediatrics.

The other severe comorbidities are: obstructive sleep apnea (Apnea-Hypopnea Index > .5), Type2 Diabetes mellitus, idiopathic intracranial hypertension (IIH), nonalcoholic steatohepatitis, SCFE, GERD, and hypertension.{{Cite journal |last1=Armstrong |first1=Sarah C. |last2=Bolling |first2=Christopher F. |last3=Michalsky |first3=Marc P. |last4=Reichard |first4=Kirk W. |last5=SECTION ON OBESITY, SECTION ON SURGERY |last6=Haemer |first6=Matthew Allen |last7=Muth |first7=Natalie Digate |last8=Rausch |first8=John Conrad |last9=Rogers |first9=Victoria Weeks |last10=Heiss |first10=Kurt F. |last11=Besner |first11=Gail Ellen |date=2019-12-01 |title=Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices |url=https://publications.aap.org/pediatrics/article/144/6/e20193223/37962/Pediatric-Metabolic-and-Bariatric-Surgery-Evidence |journal=Pediatrics |language=en |volume=144 |issue=6 |pages=e20193223 |doi=10.1542/peds.2019-3223 |pmid=31656225 |s2cid=204947687 |issn=0031-4005 |doi-access=free |access-date=2022-03-27 |archive-date=2022-03-27 |archive-url=https://web.archive.org/web/20220327161458/https://publications.aap.org/pediatrics/article/144/6/e20193223/37962/Pediatric-Metabolic-and-Bariatric-Surgery-Evidence |url-status=live }}

Blount disease is named after Walter Putnam Blount (1900–1992), an American pediatric orthopedic surgeon, who described it in 1937.{{WhoNamedIt|synd|1470}}W. P. Blount. Tibia vara: osteochondrosis deformans tibiae. Journal of Bone and Joint Surgery, Boston, 1937, 19: 1-29. It has also been known as Mau-Nilsonne syndrome, after C. Mau and H. Nilsonne, who published early case reports of the condition.Mau, C. (1923/24) Genu varum bedingt durch Tihiaepiphysendefekt bei Kartilaginärer Exostose. Z. orthop. Chir. 44, 383.Nilsonne, H. (1929) Genu varum mit eigentümlichen Epiphysenveränderungen. Acta chir. scand. 44, 187. it is today considered an acquired disease of the proximal tibial metaphysis rather than an epiphyseal dysplasia or osteochondrosis.{{Cite book|last1=Canale|first1=Terry S.|title=Campbell's Operative Orthopaedics|last2=Beaty|first2=James H.|publisher=Elsevier (Mosby)| year=2013| isbn=978-0-323-07243-4| edition=12th| location=Philadelphia| pages=1168}}

{{clear}}

{{reflist}}

• Dakshina Murthy T S. S; Alessandro De Leucio. [https://www.ncbi.nlm.nih.gov/books/NBK560923/ Blount Disease] Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

{{Medical resources

| DiseasesDB = 29304

| ICD10 = {{ICD10|M|92|5|m|91}}

| ICD9 = {{ICD9|732.4}}

| ICDO =

| OMIM = 259200

| MedlinePlus = 001584

| eMedicineSubj = radio

| eMedicineTopic = 83

| MeshID =

}}

{{Osteochondropathy}}

{{DEFAULTSORT:Blount's Disease}}

Category:Skeletal disorders

Category:Orthopedic problems

Category:Knee injuries and disorders

Category:Pediatrics

Category:Syndromes affecting bones