Blount's Disease

Blount’s Disease is a cause of progressive lower extremity bowing. It is seen in too distinct age groups, toddlers and adolescents.

Blount’s Disease arises from a growth abnormality of the growth plate just below the knee, located in the proximal tibia. For reasons not fully understood, the inside part of the growth plate slows or stops growing, while the outside part of the growth plate continues to grow normally. This results in the developing of a deformity called tibia vara. The foot becomes twisted in relative to the knee. The leg also is directed inward from the knee.

This is an image of a three-year-old male with bilateral Blount’s Disease. Notice how acute the bowing is just below his knees especially on his left side.

This is an image of a fourteen-year-old male with left Blount’s Disease.

This is an image of a fourteen-year-old male with left Blount’s Disease. Toddlers and adolescents with Blount’s Disease are generally overweight, suggesting weight may play some role in the etiology of Blount’s Disease.

For the young children with Blount’s Disease, we can treat them with a special Blount’s brace. Bracing is effective for children under three years old. After three years of age, there is usually not enough growth remaining in the tibia to allow the brace to work. For these kids, a surgical osteotomy of the tibia is performed to correct their leg alignment.

Blount's Brace

The brace has to correct both the angular and rotational deformity of the tibia. During the day, the brace is unlocked at the knee for walking. The rotational deformity is best corrected with the knee bent. At night, the brace is locked at the knee to better correct the angular deformity. Every few months the bar of the brace is bent to help correct the deformity.

Surgery to correct the deformity of Blount’s Disease is used in cases where the brace is not helpful or in adolescent patients because the brace will not work. There are several options for the type of surgery performed. When the child has sufficient growth remaining a “guided growth” procedure is done which slows down the growth of part of the proximal tibia growth plate allowing gradual correction of the deformity. For children who are almost done growing, the tibia bone has to be cut, which is called an osteotomy, and the bone realigned either slowly or acutely to correct the deformity.