Blount Disease Flashcards Preview

Peds Orthopaedics > Blount Disease > Flashcards

Flashcards in Blount Disease Deck (13):
1

Infantile definition?

pathologic genu varum from 2-5 years of age
- bilateral
- males
- more common than adolescent

2

Adolescent dfeinition?

Pathologic genu varum in >10 years of age

3

Mechanical cause?

medial overload in genetically susceptible individuals
- producing an osteochondrosis of the proximal medial tibial physis and epiphysis, which can progress to a physeal bar

4

Other causes of pathologic genu varum:

- persistent physiologic varus
- rickets
- OI
- MED, SED
- focal fibrocargilatinous defect
- TAR syndrome
- proximal physeal injury

5

Normal progression of limb axis:

genu varum until 2 years
- neutral alignment at 14 months
- peak genu valgum at 3 years
- physiologic valgus ~ 7 years of age

6

Langenskold Classification

grade I-IV with increasing medial metaphyseal beaking and sloping
- types V and VI have epiphyseal-metaphyseal bony bridge

7

What is the Blount's deformity?

tibia vara, flexion, and intenral rotation
- compensatory distal femoral valgus

8

MDA Angle

Drennan's angle
>16 degres is abnormal and has 95% risk of progression
<10 deg has 95% of natural resolution of bowing

9

Indication for KAFO?

Stage I and II in children < 3 years of age
- needs 2 years of bracing
- poor outcomes if obese and bilateral

10

Indications for Surgery?

Stage I and II in children >3 years, as well as stages III-VI in all ages
- failed brace treatment with deformity progression
- MDA >20 degrees

11

By what age should you try and perform surgery for Blount's if necesary?

by age 4!

12

What should your osteotomy correction goal be?

10-15 deg of valgus overcorrection because medial physeal growth abnormalities persist (this in young children with lots of remaining growth)

13

Treatment for Adolescent Blount?

always surgical unless very mild cases
- lateral tibia/fibula epiphysiodesis in mild deformity with remaining skeletal growth
- proximal tibia osteotomy in cases with severe deformity and skeletal maturity