Blount's disease: a retrospective review and recommendations for treatment

Thirty-two patients treated for Blount's disease were retrospectively reviewed. The results of treatment were assessed by clinical and radiographic parameters and arbitrarily classified good, fair, or poor. Five patients were definitively treated with braces; five extremities were rated good and one poor. Twelve patients were treated with a proximal tibial osteotomy performed before their fifth birthday. Nineteen extremities were rated good, one fair, and three poor. Fifteen patients had their initial surgical procedure after the fifth birthday. Eight extremities were rated good, six fair, and seven poor. Recurrence of the varus deformity secondary to an unsuspected medial bony physeal bar occurred in four patients. Resection of this bony bridge concomitant with a varus correcting osteotomy may be indicated. For severe deformity in older children, several different salvage procedures were used.