Blount’s disease: A case report

Abstract

Introduction: Blount’s disease is defined as a growth disorder of medial aspect of proximal tibia physis with abrupt medial angulation of proximal tibia distal to epiphysis, leading to varus angulation of proximal tibia and medial rotation of tibia. Epidemiology is not well established and very rarely cases have been reported from Indian subcontinent. Presentation of case: A 3-years-old female child presented with deformity in both the legs and altered walking pattern for the past one year. On examination there was 15 degrees of varus deformity in both the knees. There was 25 degrees of internal tibial torsion bilaterally. The child was managed by surgical intervention. Oblique proximal tibial osteotomy was done. Fixation was done with a single cancellous screw on both sides and immobilisation was done in above knee plaster cast. Child recovered well with correction of deformity and could walk with normal gait pattern. Discussion: The cause of Blount’s disease is still not well established. Treatment depends upon age at presentation, severity of varus deformity as determined by Langenskiold staging, and progression of the disease. Early intervention is required to avoid progression of the disease and permanent deformity. Conclusion: Blount’s disease is a very rarely encountered condition in Indian subcontinent but has a characteristic presentation. It should be included in differential diagnosis in cases presenting with pathological bowing of legs. Radiological findings and normal blood biochemistry can guide us towards the diagnosis of Blount’s disease. Keywords: Blount’s disease; Indian subcontinent; bilateral Blount’s disease, infantile Blount’s disease