Blount disease is a bending the upper part of the tibia, resulting in varus (O-shaped) or valgus (X-shaped) bone deformation. Other names for the disease: Erlacher-Blount disease, infantile tibia vara. The disease develops as a result of the defeat of epiphyseal cartilage of the tibia. Typically, Blount disease occurs in children aged 2-3 years, but often older than 6 years. Due to the deformation of bone bent legs, visual effects are very visible.
According to medical statistics, Blount disease is the second place in the structure of the lower limb deformities, in the first place – rickets. In girls the disease is diagnosed more often than boys. Varus (O-shaped) progressive bone deformity is considered one of the most complex pathologies of the musculoskeletal system in children and adolescents.
- The first symptom – shin bending in a child aged 2-3 years. Further deformation increases.
- Increased fatigue of child.
- Lameness, clumsy gait.
- The disparity in the length of the hands and feet – because of the curvature the legs become visually shorter, so hands seem unnaturally long (in some cases the hand reaches to the knee).
- The growth of the child below the average for their age group.
- Flat feet, lowering the tone of the lower limb muscles.
Currently the causes of Blount disease are not finally formulated. It is believed that the epiphyseal cartilage is deformed as a result of osteochondropathy or chondrodysplasia. Since Blount disease is often accompanied by other congenital abnormalities of development, heredity plays an important role. Factors that contribute to Blount disease: there are endocrine disorders, overweight, child immediately began to walk without crawling stage. One day there comes a time when a deformed tibia cannot withstand the increasing weight of the child – then Blount disease begins to progress particularly fast.
- The form of the disease: infantile (manifested in children aged 2-3 years, both legs are affected symmetrically) and adolescent (manifested over 6 years, usually one calf is affected).
- View of deformation: varus (O-shaped) or valgus (X-shaped). In most cases O-shaped deformation is revealed, the X-shaped – rare.
- Degree of deformation: potential, moderate, progressive and rapidly progressive.
At detection legs curving the child should be shown to the orthopedist. The doctor will examine the child and direct the x-rays of joints. X-ray research gives a complete picture of the diagnosis of the Blount disease: tibia is curved, articular surface of the bone is tapered at an angle, cortical layer on the inner surface of the bones is thickened, etc. The differential diagnosis is usually not necessary. Additionally, for the research of cartilage, computed tomography of the knee joint and MR knee can be performed.
Self-treatment of Blount disease is unacceptable, you should go to the orthopedist. The choice of method of treatment depends on the stage of the disease, the amount of deformation, the child’s age, individual features of the disease.
With little pathology massage and physiotherapy exercises are used, aimed at correcting deviations. You can do physiotherapy exercises at home, but a complex of exercises should be appointed by a physician. In addition, hyperbaric oxygen therapy (HBO) is used. If you have flat feet, it’s recommended to wear special orthopedic shoes and do additional exercises. Sometimes doctors prescribe drugs to stimulate specific muscles.
Severe deformity of the tibia may result in deforming arthrosis. To avoid such complications, it is necessary to urgently adopt a set of preventive measures: plaster bandages, orthopedic braces, orthopedic devices inarticulate, UV irradiation.
If Blount disease is detected in a child older than 3 years, the treatment is carried out using the Ilizarov apparatus. If the curve is not cleared in the child until the age of 5-6 years, surgery is required. The most effective method is operational – osteostomiya tibia. It happens that doctors have to carry out further lower osteotomy of the fibula. Also, special attention is given to the knee joint, if necessary, the plastic ligaments is performed.
If Blount disease is not treated, the deformation will only increase, leading to serious complications. If the correction has been launched in a timely manner (up to the operation), the prognosis is favorable: the child can stand firmly on its feet and be perfectly healthy.
Parents should monitor the baby’s weight, because overweight becomes a predisposing factor to bone deformation, so do not overfeed the baby, make a massage and special exercises, the child should move more.
Do not rush the baby to start walking as soon as possible. Muscles children develop gradually: first, they get stronger enough to ensure that the baby could roll over on stomach, then sit, then crawl, and only then take the first steps.
Do not forget to give your child vitamin D during the first year of life – this vitamin strengthens bones. Typically, pediatricians prescribe mandatory, but not all parents comply with these recommendations.
At the age of 1 year old baby has to go all the major doctors. Do not forget to show your baby orthopedist, let an expert examination of the child, even if the apparent abnormalities or deformations are not noticed. Early diagnosis and timely treatment of Blount disease significantly increase the likelihood of a speedy recovery.