0
Current Concepts Review   |    
Blount Disease
Sanjeev Sabharwal, MD1
1 Department of Orthopedics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Doctor's Office Center, 90 Bergen Street, Suite 7300, Newark, NJ 07103. E-mail address: sabharsa@umdnj.edu
View Disclosures and Other Information
Disclosure: The author did not receive any outside funding or grants in support of his research for or preparation of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (Smith and Nephew) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the author, or a member of his immediate family, is affiliated or associated.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Jul 01;91(7):1758-1776. doi: 10.2106/JBJS.H.01348
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

Two clinically distinct forms of Blount disease (early-onset and late-onset), based on whether the lower-limb deformity develops before or after the age of four years, have been described.

Although the etiology of Blount disease may be multifactorial, the strong association with childhood obesity suggests a mechanical basis.

A comprehensive analysis of multiplanar deformities in the lower extremity reveals tibial varus, procurvatum, and internal torsion along with limb shortening. Additionally, distal femoral varus is commonly noted in the late-onset form.

When a patient has early-onset disease, a realignment tibial osteotomy before the age of four years decreases the risk of recurrent deformity.

Gradual correction with distraction osteogenesis is an effective means of achieving an accurate multiplanar correction, especially in patients with late-onset disease.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Alan Aner
    Posted on December 13, 2009
    Simple One-Stage Correction for Blount Disease
    NULL

    To the Editor:

    Our congratulations to the authors of this excellent review (1). We wish to call their attention to a very simple technique which allows us to perform multidirectional corrections in early-onset Blount disease - the Haas procedure. It allows us also to do further alignment changes ten days after surgery without sedation or anesthesia and has a very low complication rate. We published our results in 2007 (2).

    The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

    References

    1. Sabharwal S. Blount disease. J Bone Joint Surg Am. 2009;91:1758-76.

    2. Dror L, Alan A, Leonel C. The Haas procedure for the treatment of tibial torsional deformities. J Pediatr Orthop B. 2007;16:120-4.

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    12/31/2013
    S. Carolina - Department of Orthopaedic Surgery Medical Univerity of South Carlonina
    02/28/2014
    District of Columbia (DC) - Children's National Medical Center
    12/04/2013
    New York - Icahn School of Medicine at Mount Sinai
    04/02/2014
    W. Virginia - Charleston Area Medical Center