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Blount’s disease, also known as tibia vara, is a condition in which growth does not occur normally in the growth plates of the lower leg, resulting in deformities that may differ in direction and severity.
Its estimated prevalence in the United States is less than 1 percent, but the effects can be distressing.1
Severe bowing of the legs can also result, causing pain and mobility issues. It is different from physiological bow legs, which tend to straighten as the child grows; your doctor will be able to tell you which your child is experiencing.
It occurs in young children and adolescents. The cause is not certain; it seems to be associated with early walking and above-average weight, and may be caused by the effects of weight on the growth plates. There is a definite genetic element and some patient groups, such as African Americans, seem more likely to develop Blount’s disease.
One or both legs may show bowing, which typically occurs just below the knee and may progress rapidly and unevenly.
In younger children and less severe cases, a corrective leg brace or orthotic may be used to manage the limb deformity. Another option is surgery to attach a guided-growth plate system. This inhibits the bone growth on one side of the deformity and allows the opposite side to catch up, straightening the leg. This may be all that is required in less severe cases.
In more severe deformities, an operation called an osteotomy (the surgical cutting or removal of a piece of bone to change how bones line up) may be required. After osteotomy, either external or internal fixation will be used to hold the new bone in place. Osteotomy was once the most often used form of surgical management in severe Blount’s disease. If caught early enough, guided growth may be used instead in some cases. 2,3
If Blount’s disease is not treated, the symptoms can get worse, causing different leg lengths, pain and trouble walking. The condition can come back after surgery, especially in younger children who are still growing. A specialist can help you determine the right time to perform any surgery.
The Guided Growth System eight-Plate and quad-Plate is an implant system designed to correct pediatric deformities (congenital or acquired) in lower limb, like genu valgum and varum, and limb length discrepancies. The plates are attached to the external surface of the bone over the growth plate by two or four screws depending on the plate selected by the surgeon. The implant acts like a flexible hinge, permitting growth at the growth plate to gradually straighten the limb when the physis (growth plates) are not fused. The screws are not locked to the plate but rather are allowed to swivel and diverge in their positions as the bone grows. Immediately after implantation, the patient is allowed mobility and weight bearing.
The eight-Plate Guided Growth System+™ is an implant system designed to correct pediatric deformities (congenital or acquired) in lower limb, like genu valgum and varum, and limb length discrepancies. The plates are attached to the external surface of the bone over the growth plate by two or four screws depending on the plate selected by the surgeon. The implant acts like a flexible hinge, permitting growth at the growth plate to gradually straighten the limb when the physis (growth plates) are not fused. The screws are not locked to the plate but rather are allowed to swivel and diverge in their positions as the bone grows. Immediately after implantation, the patient is allowed mobility and weight bearing. The eight-Plate Guided Growth System+ offers more sizes and different screw types compared to the standard eight-Plate Guided Growth System, as well as an increased screw angle to treat very difficult cases.
TL-HEX is a dynamic, 3D external fixation system that combines hardware and software to correct bone deformities. This hexapod-based system functions as a 3D bone segment-repositioning module. In essence, the system consists of circular and semi-circular external supports secured to the bones by wires and half-pins, interconnected by six struts.
The Ilizarov System has experienced many modifications over the last fifty years. The TrueLok™ Ring Fixation System, developed at Texas Scottish Rite Hospital for Children (TSRHC) in Dallas, Texas, is one of the modern variants of the original fixator, but preserves many of the original principles of Professor Ilizarov. It consists of aluminum rings available in different sizes, connected to the bone through metal wires or/and bone screws. The relative movements of the rings allow the correction of almost all the bone deformities in upper and lower limbs and in the foot.
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