Venkata Shyam Prasad Polisetty, Lakshmi Sumana Voruganti
BACKGROUND In the year 1937, Walter Blount from Milwaukee gave description of this condition called tibia vara in his classic article. Blount described tibia vara as "an osteochondrosis of the medial side of the proximal tibial epiphysis." However, currently, tibia vara is considered an acquired disease of the proximal tibial metaphysis, rather than an epiphyseal dysplasia or osteochondrosis. This disease is characterized by an abrupt angulation of the proximal end of tibia into a progressive varus deformity. The objectives of this study were to evaluate the clinical and radiological aspects of Blount’s disease and to study various treatment options available and their results. MATERIAL AND METHODS This is retrospective study conducted in department of Orthopaedics, King George Hospital, Visakhapatnam, in patients who had been diagnosed with unilateral or bilateral Blount's disease during the period of 2012 to 2017, after obtaining permission from institutional ethics committee. Twenty-one patients were included in the sample. There were 13 females and 8 males. All the cases in the sample were radiological confirmed cases of Blount disease with a progressive bowing and a metaphyseal- diaphyseal angle of more than eleven degrees and were graded with Langenskiold types. The adolescent group was further separated with early onset (8-13 years) and late onset (above 13 years). RESULTS Incidence of Blount’s is more common in females left tibia was involved in eleven children. Internal torsion was same before and after osteotomies. Range of varus was 15 degrees to 50 degrees. Average m-d angle was 26 degrees. Grading of result was done on basis of femorotibial mechanical axis. CONCLUSION Langenskiold grading has no prognostic effect. Metaphyseal-diaphyseal angle was useful in making diagnosis. There is no correlation between recurrence of varus deformity and preoperative deformity angle. Fixation with pins or staples is not a factor. Metaphyseal osteotomies have high incidence for recurrence, limb length discrepancy and subluxation of knee joint.
