Infantile Tibia Vara (Blount Disease) with Iatrogenic Changes Causing Residual Tibial Deformities

TitleInfantile Tibia Vara (Blount Disease) with Iatrogenic Changes Causing Residual Tibial Deformities
Publication TypeJournal Article
Year of Publication2020
AuthorsOleas-Santillán, G., Kazmi F. K., Thacker M. M., Harcke H. T., Lawall H., & Bowen J. R.
JournalJournal of surgical orthopaedic advances
Volume29
Issue3
Pagination141-148
Date Published2020 Summer
ISSN1548-825X
KeywordsBone Diseases, Developmental; Child, Preschool; Humans; Iatrogenic Disease; Infant; Osteochondrosis; Tibia
Abstract

Treatment of infantile tibia vara or Blount disease (ITV/BD) in patients < 3 years old and Langenskiold stages I-III consists of orthosis and, in relapsing cases, proximal tibial osteotomy and/or proximal tibial guided growth laterally with a tension band plate. Our aim was to evaluate the results of treatments in a consecutive group. After Institutional Review Board approval, data from 2002 to 2018 were collected. Thirty-nine knees (average age 22.4 months) with ITV/BD were treated with orthoses, and 10 knees failed. Six knees showed hyperintense T2-weighted signal in the medial proximal tibial epiphyseal cartilage on magnetic resonance imaging. Three of six knees with tibial osteotomy failed and underwent guided growth. Tibial plateau slopes were abnormal medially from the ITV/BD and laterally from the guided growth (triangular physis and depressed plateau deformities) because of factors such as orthotic treatment, tibial osteotomy, magnetic resonance imaging "physis severity score," and guided growth. (Journal of Surgical Orthopaedic Advances 29(3):141-148, 2020).

Alternate JournalJ Surg Orthop Adv
Refereed DesignationRefereed