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Juvenile Blount's disease: bilateral case with asynchronous onset.
Kazumi Shimode1, Noboru Miyagi, Yoshimitsu Aoki
1Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan.
Summary
This case highlights a rare unilateral presentation of bilateral juvenile Blount's disease. Early detection and tailored treatment are crucial for managing this complex orthopedic condition.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Skeletal Dysplasias
Background:
- Juvenile Blount's disease is a developmental disorder affecting the proximal tibia, leading to progressive varus deformity.
- Bilateral involvement is common, often presenting with nearly synchronous onset of deformity.
Observation:
- A 9-year-old girl presented with unilateral left knee varus deformity and tibial shortness.
- Initial diagnosis was unilateral, but the contralateral knee (right) showed progressive varus deformity during follow-up.
Findings:
- The patient underwent corrective surgery using the callotasis method with an Orthofix external fixator for the left knee.
- Later, the right knee deformity was addressed with callotasis and proximal epiphysiodesis, achieving good coronal-plane alignment in both knees.
Implications:
- Unilateral presentation of bilateral juvenile Blount's disease necessitates thorough bilateral assessment (tomography or MRI) beyond standard radiography.
- Treatment planning must consider potential leg-length discrepancies in managing asynchronous bilateral cases.