This 2009 JBJS current concepts review by Sabharwal synthesizes the classification, pathogenesis, imaging workup, and operative management of Blount disease — a developmental disorder of the proximal tibial physis causing progressive multiplanar lower-limb deformity — across both early-onset (before age 4) and late-onset (after age 4) forms.
When you see a young child with tibia vara, the age-4 cutoff is your most important variable: early osteotomy cuts recurrence risk nearly in half, but always obtain full-length standing radiographs first — missing distal femoral varus in a late-onset case will leave a third of the deformity uncorrected.
In any obese adolescent with Blount disease heading to the OR, order a sleep study. More than half will have undiagnosed sleep apnea requiring preoperative NIPPV.
This 2009 JBJS current concepts review by Sabharwal synthesizes the classification, pathogenesis, imaging workup, and operative management of Blount disease — a developmental disorder of the proximal tibial physis causing progressive multiplanar lower-limb deformity — across both early-onset (before age 4) and late-onset (after age 4) forms.
When you see a young child with tibia vara, the age-4 cutoff is your most important variable: early osteotomy cuts recurrence risk nearly in half, but always obtain full-length standing radiographs first — missing distal femoral varus in a late-onset case will leave a third of the deformity uncorrected.
In any obese adolescent with Blount disease heading to the OR, order a sleep study. More than half will have undiagnosed sleep apnea requiring preoperative NIPPV.