OrthoNet

Blount’s Disease
Approach to Blount’s Disease (Infantile Tibia Vara)

First - make sure you are actually dealing with Blount’s disease and not some weird skeletal dysplasia or rickets!

Assess the x-rays
- note the metaphyseal diaphyseal angle and the medial physeal slope
- note the Langenskiold staging (I to VI)
- I and II have mild varus with no major sloping of the tibial physis
- III and IV have some tilting over of the physis
- VI and VI have a significant angulation of the physis
- consider a bony bar in anything from III to VI (most commonly IV, V, VI)

Decision Making - you want the legs to be normal by the age of FOUR - this significantly influences what you do

General Indications for Bracing
- first time visit 36 months of age - you have no time to waste before the age of 4 to be fucking around with bracing.
- documented progression in the KAFO at any age
- metaphyseal diaphyseal angle of 60 or more at any age
- the