Blount’s Disease
One of the diseases in which limb-lengthening techniques are used is in cases of Blount’s Disease. The surgeons at the Hospital for Joint Diseases Center for Children have a great amount of experience in dealing with this uncommon growth disorder and have also written about it extensively.
Definition
Blount’s Disease or, Tibia Vara, is associated with a bowing of the legs in children, usually between the ages of 2-3 years or sometimes in older children 8-13 years of age. Although bowing in children is normal up to age 2, this bowing should fix itself between the ages of 2 and 3. If it does not then, Blount’s Disease is probably the diagnosis. Although there are some other diseases, such as rickets that causes bowing, Blount’s Disease is the most common cause of bowing in children. At the Hospital for Joint Diseases Center for Children we have been successful in treating children using a brace. Surgery is also an option and has been performed successfully in children with Blount’s. When treated early, we use surgery to attach an external form such as the Taylor Spatial Frame in order to prevent recurrence. This allows the child to walk and maintain normal function while the correction is being done.
Causes
The cause of Blount’s Disease is not known.
Risk Factors
As the cause is unknown, risk factor is not known.
Diagnosis
A physical examination shows that the lower legs angle inward and an x-ray can confirm the diagnosis.
Treatment
Surgical Care
Surgery involves cutting the shin bone to realign it, and sometimes to lengthen it as well. Other methods include allowing the child’s growth to reverse the bowing process by surgically restricting the outer half of the shin bone. A device used is the Internal Fixation Osteotomy Devices and pins and screws may be used to hold it in place. External fixation Osteotomy is a circular wire frame on the outside of the leg with pins to hold the device in place.
Non-surgical Care
Children may be treated with bracing and if bracing fails, or if bowing is not detected until the child is older, surgery can be required for patients of Blount’s Disease. The brace commonly used is a KAFP brace which stands for Knee-Ankle-Foot Prosthetic. The brace begins at the top of the thigh and extends to the tip of the toes, following underneath the foot.
Prevention
There is no known way to prevent Blount’s Disease.
Case Examples
Click here to see a case example.
Resources
The New York Institute for Limb Lengthening and Reconstruction
http://www.med.nyu.edu/hjd/centerforchildren/patient/limb.html
The Wallace B. Lehman, M.D. Center for Pediatric Orthopedic Surgery
http://www.nyuhjd.org/hjd/centerforchildren/patient/wallace.html
The Center for Pediatric Rehabilitation and Pediatric Medicine
http://www.nyuhjd.org/hjd/centerforchildren/patient/ped_rehab.html
The NYU Hospital for Joint Diseases Pediatric Physical and Occupational Therapy Department
http://www.nyuhjd.org/hjd/centerforchildren/patient/rehabilitation.html
Child Life Program at Center for Children
http://www.nyuhjd.org/hjd/centerforchildren/patient/child_life.html
Music Therapy at Center for Children
http://www.nyuhjd.org/hjd/centerforchildren/patient/music_therapy.html
To make an appointment at the NYU Hospital for Joint Diseases Center for Children, please call 212-598-6205