Infantile Tibia Vara (Blount Disease) with Iatrogenic Changes Causing Residual Tibial Deformities

Area of Science:

• Pediatric Orthopedics
• Skeletal Dysplasias
• Biomechanical Engineering

Background:

• Infantile tibia vara (ITV/BD) is a progressive condition affecting children under 3 years old.
• Current treatments include orthosis, proximal tibial osteotomy, and guided growth.
• Relapsing cases present unique management challenges.

Purpose of the Study:

• To evaluate treatment outcomes for infantile tibia vara (ITV/BD) in young patients.
• To assess the effectiveness of orthotic and surgical interventions.
• To identify factors contributing to treatment success or failure.

Main Methods:

• Retrospective review of 39 knees in patients with ITV/BD (average age 22.4 months) treated from 2002-2018.
• Analysis of treatment modalities including orthoses, tibial osteotomy, and guided growth.
• Correlation of magnetic resonance imaging findings with clinical outcomes.

Main Results:

• Orthotic treatment failed in 10 of 39 knees.
• Three of six knees undergoing tibial osteotomy failed and required guided growth.
• Abnormal tibial plateau slopes (medial and lateral) were observed post-treatment, linked to interventions and imaging scores.

Conclusions:

• Treatment of infantile tibia vara (ITV/BD) in young children can be complex with a significant failure rate.
• Surgical interventions like osteotomy and guided growth may lead to secondary deformities.
• Further research is needed to optimize treatment strategies and prevent long-term tibial plateau abnormalities.