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Blount disease, adolescent

MedGen UID:
462922
•Concept ID:
C3151572
•
Disease or Syndrome
Synonyms: OSTEOCHONDROSIS DEFORMANS TIBIAE, ADOLESCENT; TIBIA VARA, ADOLESCENT
 
Monarch Initiative: MONDO:0009800
OMIM®: 259200

Definition

Blount disease is a developmental condition characterized by disordered endochondral ossification of the medial part of the proximal tibial physis resulting in multiplanar deformities of the lower limb (review by Sabharwal, 2009). [from OMIM]

Clinical features

From HPO
Genu varum
MedGen UID:
154257
•Concept ID:
C0544755
•
Finding
A positional abnormality marked by outward bowing of the legs in which the knees stay wide apart when a person stands with the feet and ankles together.
See: Feature record | Search on this feature
Osteochondritis dissecans
MedGen UID:
10494
•Concept ID:
C0029421
•
Disease or Syndrome
A joint disorder caused by blood deprivation in the subchondral bone causing the subchondral bone to die in a process called avascular necrosis. The bone is then reabsorbed by the body, leaving the articular cartilage it supported prone to damage. The result is fragmentation (dissection) of both cartilage and bone, and the free movement of these osteochondral fragments within the joint space, causing pain and further damage.
See: Feature record | Search on this feature
Bowing of the legs
MedGen UID:
1807399
•Concept ID:
C5574706
•
Finding
A bending or abnormal curvature affecting a long bone of the leg.
See: Feature record | Search on this feature
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Professional guidelines

PubMed

Update on treatment of adolescent Blount disease.
de Pablos J, Arbeloa-Gutierrez L, Arenas-Miquelez A
Curr Opin Pediatr 2018 Feb;30(1):71-77. doi: 10.1097/MOP.0000000000000569. PMID: 29315109
Treatment of Adolescent Blount Disease Using Taylor Spatial Frame With and Without Fibular Osteotomy: Is There any Difference?
Sachs O, Katzman A, Abu-Johar E, Eidelman M
J Pediatr Orthop 2015 Jul-Aug;35(5):501-6. doi: 10.1097/BPO.0000000000000317. PMID: 25321881

Recent clinical studies

Etiology

New Single-stage Double Osteotomy for Late-presenting Infantile Tibia Vara: A Comprehensive Approach.
Abraham E, Toby D, Welborn MC, Helder CW, Murphy A
J Pediatr Orthop 2019 May/Jun;39(5):247-256. doi: 10.1097/BPO.0000000000000926. PMID: 30969255Free PMC Article
Blount disease.
Janoyer M
Orthop Traumatol Surg Res 2019 Feb;105(1S):S111-S121. Epub 2018 Feb 23 doi: 10.1016/j.otsr.2018.01.009. PMID: 29481866
A modified Puddu technique for the treatment of adolescent mild to moderate tibia vara.
Khanfour AA
J Pediatr Orthop B 2016 Jan;25(1):37-42. doi: 10.1097/BPB.0000000000000233. PMID: 26426507
High tibial osteotomy in young adults with constitutional tibia vara.
Masrouha KZ, Sraj S, Lakkis S, Saghieh S
Knee Surg Sports Traumatol Arthrosc 2011 Jan;19(1):89-93. Epub 2010 Apr 22 doi: 10.1007/s00167-010-1148-7. PMID: 20411373
Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee.
Wiemann JM 4th, Tryon C, Szalay EA
J Pediatr Orthop 2009 Jul-Aug;29(5):481-5. doi: 10.1097/BPO.0b013e3181aa24a8. PMID: 19568021

Diagnosis

Blount disease.
Janoyer M
Orthop Traumatol Surg Res 2019 Feb;105(1S):S111-S121. Epub 2018 Feb 23 doi: 10.1016/j.otsr.2018.01.009. PMID: 29481866
Pediatric orthopaedics.
Parikh SN
Orthop Clin North Am 2015 Jan;46(1):xxi. Epub 2014 Oct 11 doi: 10.1016/j.ocl.2014.09.019. PMID: 25435049
Blount disease: an update.
Sabharwal S
Orthop Clin North Am 2015 Jan;46(1):37-47. Epub 2014 Oct 12 doi: 10.1016/j.ocl.2014.09.002. PMID: 25435033
Blount disease.
Birch JG
J Am Acad Orthop Surg 2013 Jul;21(7):408-18. doi: 10.5435/JAAOS-21-07-408. PMID: 23818028
Does Langenskiold staging have a good prognostic value in late onset tibia vara?
Khanfour AA
J Orthop Surg Res 2012 Jun 7;7:23. doi: 10.1186/1749-799X-7-23. PMID: 22676471Free PMC Article

Therapy

Tension Band Plate (TBP)-guided Hemiepiphysiodesis in Blount Disease: 10-Year Single-center Experience With a Systematic Review of Literature.
Jain MJ, Inneh IA, Zhu H, Phillips WA
J Pediatr Orthop 2020 Feb;40(2):e138-e143. doi: 10.1097/BPO.0000000000001393. PMID: 31022017
Treatment of Infantile Blount Disease: An Update.
Sabharwal S, Sabharwal S
J Pediatr Orthop 2017 Sep;37 Suppl 2:S26-S31. doi: 10.1097/BPO.0000000000001027. PMID: 28799991
Spectrum of paediatric rheumatic diseases in Nigeria.
Olaosebikan BH, Adelowo OO, Animashaun BA, Akintayo RO
Pediatr Rheumatol Online J 2017 Jan 31;15(1):7. doi: 10.1186/s12969-017-0139-3. PMID: 28143550Free PMC Article
Treatment of Adolescent Blount Disease Using Taylor Spatial Frame With and Without Fibular Osteotomy: Is There any Difference?
Sachs O, Katzman A, Abu-Johar E, Eidelman M
J Pediatr Orthop 2015 Jul-Aug;35(5):501-6. doi: 10.1097/BPO.0000000000000317. PMID: 25321881
Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee.
Wiemann JM 4th, Tryon C, Szalay EA
J Pediatr Orthop 2009 Jul-Aug;29(5):481-5. doi: 10.1097/BPO.0b013e3181aa24a8. PMID: 19568021

Prognosis

Blount disease.
Janoyer M
Orthop Traumatol Surg Res 2019 Feb;105(1S):S111-S121. Epub 2018 Feb 23 doi: 10.1016/j.otsr.2018.01.009. PMID: 29481866
Does Langenskiold staging have a good prognostic value in late onset tibia vara?
Khanfour AA
J Orthop Surg Res 2012 Jun 7;7:23. doi: 10.1186/1749-799X-7-23. PMID: 22676471Free PMC Article
Orthopaedic manifestations in a case of Lenz microphthalmia syndrome.
Derman PB, Kulkarni SS, Dormans JP
J Pediatr Orthop 2011 Sep;31(6):e64-9. doi: 10.1097/BPO.0b013e3182210923. PMID: 21841432
Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee.
Wiemann JM 4th, Tryon C, Szalay EA
J Pediatr Orthop 2009 Jul-Aug;29(5):481-5. doi: 10.1097/BPO.0b013e3181aa24a8. PMID: 19568021
Blount disease: a review of the English literature.
Bradway JK, Klassen RA, Peterson HA
J Pediatr Orthop 1987 Jul-Aug;7(4):472-80. PMID: 3301898

Clinical prediction guides

Blount disease.
Janoyer M
Orthop Traumatol Surg Res 2019 Feb;105(1S):S111-S121. Epub 2018 Feb 23 doi: 10.1016/j.otsr.2018.01.009. PMID: 29481866
A modified Puddu technique for the treatment of adolescent mild to moderate tibia vara.
Khanfour AA
J Pediatr Orthop B 2016 Jan;25(1):37-42. doi: 10.1097/BPB.0000000000000233. PMID: 26426507
Blount disease.
Birch JG
J Am Acad Orthop Surg 2013 Jul;21(7):408-18. doi: 10.5435/JAAOS-21-07-408. PMID: 23818028
High tibial osteotomy in young adults with constitutional tibia vara.
Masrouha KZ, Sraj S, Lakkis S, Saghieh S
Knee Surg Sports Traumatol Arthrosc 2011 Jan;19(1):89-93. Epub 2010 Apr 22 doi: 10.1007/s00167-010-1148-7. PMID: 20411373
Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee.
Wiemann JM 4th, Tryon C, Szalay EA
J Pediatr Orthop 2009 Jul-Aug;29(5):481-5. doi: 10.1097/BPO.0b013e3181aa24a8. PMID: 19568021

Recent systematic reviews

Tension Band Plate (TBP)-guided Hemiepiphysiodesis in Blount Disease: 10-Year Single-center Experience With a Systematic Review of Literature.
Jain MJ, Inneh IA, Zhu H, Phillips WA
J Pediatr Orthop 2020 Feb;40(2):e138-e143. doi: 10.1097/BPO.0000000000001393. PMID: 31022017

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