Blount's Disease (Tibia Vara)

Introduction
Progressive bow-leg deformity
(genu varum) - Pathologic
Due to abnormal growth of
posteromedial part of the proximal
tibia
Deformity is noticeably worse than
in physiological bow legs

Types:-
1. Infantile - < 3yo, associated with
obesity, early walking
2. Adolescent - > 8yo, insidious onset
Presentation
History:-
Parents noticed a deformity

Physical Examination:-
Unilateral / Bilateral genu varum
Bony prominence over medial
tibial condyle
Feet held in pronation
Shortening of involved leg
Gait - Varus thrust
X-Ray
Tibia metadiaphyseal angle
(TMDA)
<9 is normal,
>16 is pathological/ Blount's
disease
Treatment
Physiologic:
Observation
Infantile:
<3 yo - Brace (Hip-knee-ankle-
foot orthosis - HKAFO
>3 yo - Osteotomy
Adolescent:
Hemiepiphysiodesis
or Osteotomy