Blount’s Disease

By Allan O. Fiesta, PT, DPT, OCS

What is Blount’s Disease?

Blount’s disease is a rare growth disorder that affects children. It causes the legs to bow outwards below the knees (tibia vara). The growth plate near the inside of the knee slows down or stops making new bone and the growth plate near the outside of the knee continues to grow normally. This causes a bowlegged appearance in one or both legs.

X-ray image of bowed legs from an individual suffering with Blount's disease. JOI Rehab

X-Ray image of an individual who has Blount’s disease

There are two types of Blount’s Disease: Infantile and Adolescent.

Infantile Blount’s Disease

Bowed legs are normal in children under age 2 and usually improve by 18 to 24 months. Infantile Blount’s disease generally appears around the same age, but instead of improving the bowing worsens over time. It occurs between the ages of newborn to 3 years old and usually occurs in both legs. The deformity is in the tibia (shin bone) only and is more common than the adolescent type. Children with infantile Blount’s disease are typically early walkers (before 12 months) and can often be overweight.

Adolescent Blount’s Disease

This occurs in children over 10 years of age and is more likely to affect one side only. The deformity typically occurs in both the femur (thigh bone) and the tibia. In adolescents this disease may be related to rapid weight gain or obesity. This disease tends to run in families so there is also believed to be a genetic component.

How is Blount’s Disease diagnosed and who does it affect?

The diagnosis of Blount’s disease is by physical exam and X-ray. If the disease is suspected, x-rays will be performed. This  is a condition that can occur in toddlers and adolescents. The exact cause of this disease is unknown.

Image of an African American family with a bow legged baby without Blount's Disease. JOI Rehab

Bowed Legs is not always an indicator of Blount’s Disease.

What is the treatment for Blount Disease?

The goal of treatment for Blount’s disease is to correct the deformity and improve alignment of the legs.

The infantile form of this disease does require treatment for the bowing to improve. If the disease is caught early, treatment with a brace may be effective. The goal of bracing is to guide the legs into a straighter position as the child grows. An improvement usually occurs within 12 months of treatment. If bowing does not improve with the use of a brace, surgery will be a requirement by the age of 4 years. Surgery is required to stop further worsening and prevent permanent damage to the growth area of the shinbone.

Older children with bowed legs due to this disease as an adolescent generally require surgery to correct the problem as bracing is not effective. Children with severe deformities and those who are no longer candidates for bracing may also need surgery. Several surgeries are available to treat Blount’s disease, including osteotomies and hemiepiphysiodesis.

Is Blount Disease Curable?

Once the deformity is corrected, most children can resume their normal activities without limitations. However, it’s important to monitor with an orthopaedic specialist for worsening deformities or differences in leg lengths that may result from this disease. All children, especially those with Blount’s disease, benefit from maintaining a healthy weight to decrease stress on the joints over time.

Written by: Allan O. Fiesta, PT, DPT, OCS

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