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Late-onset tibia vara: a comparative analysis.

G H Thompson, J R Carter, C W Smith

    Journal of Pediatric Orthopedics
    |March 1, 1984
    PubMed
    Summary
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    Idiopathic late-onset tibia vara, or adolescent Blount's disease, presents with obesity and knee pain. Surgical correction shows high recurrence in juvenile males, suggesting distinct disease forms.

    Area of Science:

    • Orthopedics
    • Pediatric Orthopedics
    • Skeletal Dysplasias

    Background:

    • Idiopathic late-onset tibia vara (adolescent Blount's disease) is a progressive genu varum deformity.
    • Characterized by obesity, knee pain, and specific radiographic findings in children.

    Purpose of the Study:

    • To review clinical and radiographic features of adolescent Blount's disease.
    • To evaluate treatment response and identify recurrence factors.
    • To propose classification based on age of onset.

    Main Methods:

    • Retrospective review of 11 children (16 knees) with idiopathic late-onset tibia vara.
    • Analysis of clinical presentation, radiographic measurements, and surgical outcomes.
    • Histopathologic examination of physeal tissue in one case.

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    Main Results:

    • Consistent presentation: black race, male predominance, obesity, knee pain, progressive varus deformity (avg. 19 degrees).
    • Radiographic findings: wedge-shaped epiphyses, irregular physes, minimal metaphyseal prominence.
    • 50% recurrence rate in males with onset ≤10 years; no recurrences in females and older males.

    Conclusions:

    • Late-onset tibia vara is a distinct entity related to infantile Blount's disease.
    • Three forms suggested: infantile (0-3 yrs), juvenile (4-10 yrs), and adolescent (≥11 yrs).
    • Juvenile group shows high surgical recurrence; infantile and adolescent groups do not.