Blount’s disease is a child’s disease, which leads to the distortion of the tibia. Pathology can occur either before the age of three, or in children who are already six years old. The mechanism and causes of such an ailment are unknown, however, clinicians distinguish a rather narrow group of predisposing factors and starting points.
In addition to the apparent deformity, the clinical picture includes signs such as flat feet, decreased motor functions and shortened limbs. Any unpleasant sensations for such a disease are not typical.
In order to make the correct diagnosis there are no special problems, because the ailment has a rather specific symptomatology. Nevertheless, in addition, instrumental examinations of the patient, including x-rays, are required.
Treatment in the vast majority of cases is surgical.
For today, the reasons for the development of such a disorder remain unknown, but it is assumed that this can give rise to a lesion of the tibia, namely, its epiphyseal cartilage in the condyle zone.
Some experts believe that such a disorder is associated with such pathological conditions:
It is also possible that the pathology is combined with other anomalies in the development of the innate character. In addition, the effect of weighed heredity is considered.
Among the predisposing factors are:
- Excessive body weight
- Previously started walking means the absence of a crawl stage
- foot injury in infancy;
- complicated course of diseases of infectious nature
- disruption of endocrine system functioning
The starting element is an excessive load of an unprepared musculoskeletal apparatus, which is combined with some anatomical versions of the structure of the lower limbs.
Separately, the following factors are highlighted: lack of vitamin D — lack of food intake, digestive disorders or individual intolerance can affect the formation of a genetic mutation, which ultimately leads to the expression of signs of such a disease.
Depending on what age category the child was in the expression of the first symptomatology, Erlacher Blount’s disease is divided into several forms:
- Infant — characterized by the ability to diagnose an ailment in infants up to three years old
- juvenile — manifested in the period from four to ten years;
- adolescent — develops at the age of eleven.
Depending on the deformity of the lower extremities are distinguished:
- curvature of the legs of the varus character is the most common form of the disease, in which the legs are O-shaped
- curvature of the calves of the valgus character — is diagnosed extremely rarely and is expressed in that the lower limbs resemble the letter X.
In terms of severity of deformation, several types of Blaunth disease are distinguished:
- potential — the curvature does not exceed fifteen degrees and is expressed in the marginal sclerosis of the upper part of the tibia. At the same time, the inner side is subjected to a violation several times more often than the outer one
- moderately pronounced — the curvature reaches twenty-five degrees;
- Progressive — the deflection angle does not exceed thirty degrees;
- fast-moving — the deformation reaches forty degrees;
- Complicated — The angle of curvature is forty or more degrees.
Symptoms of pathology are completely absent until two or three years. This is due to the fact that until this time the baby can not walk confidently yet.
First of all, the curvature of the shins begins to appear in the clinical picture — if you do not seek qualified help in a timely manner, the deformation will gradually increase.
Thus, the concomitant external manifestations of Blount’s disease will be:
- shortening of the limbs, making the arms seem too long against the background of the whole body. There are cases when the fingers of the hand reach the level of the knee cap;
- «duck» gait
- lowering the tone of the muscles of the lower limbs;
- flat feet
- formation of the beak-shaped protrusion on the tibia
- atrophy of the calf muscles
- significant limitation of motor function;
- the awkwardness of the gait;
- fast fatigue of the baby;
- Low growth — often below the average for their age category
Despite the fact that Erlacher Blaunth’s disease has a pronounced and specific symptomatology, diagnosis is based on instrumental examinations of the patient. However, first of all, the clinician must perform several manipulations independently;
- study the medical history of the small patient and his parents
- collect a life history;
- conduct a thorough physical examination of the lower limbs;
- interview parents in detail — to find out when the first signs of pathology appeared.
Laboratory studies of blood, urine and stool during the diagnosis of Blount disease are not carried out, because they do not carry a diagnostic value.
Instrumental diagnostic measures suggest carrying out:
- X-rays of the knee joints
- CT — for studying the condition of bone and cartilage tissue in the upper regions of the tibia
- MRI — for evaluating the structure of soft tissues
The last two procedures are auxiliary, and the basis for diagnosis is radiography, since the x-ray will indicate:
- tibia of the tibia — the deformation will look like a beak
- The uniform concave shape of the articular surface of this bone, which will also be oblique at an angle. It is often found high mineralization;
- the expanded area of growth of the internal part of the affected bone
- fuzzy contours of the osseous-closing plate
- thickening of the cortical layer
- layering of shadows of small and large shin bone.
The need for differential diagnosis is completely absent.
The scheme of therapy of Blaunth disease in children will differ depending on the degree of deformation. For example, with a minor violation, the treatment consists of:
- undergoing a course of therapeutic massage
- Performing exercise therapy
- physiotherapy procedures using paraffin and mud applications
- taking medications to stimulate the muscles
- wearing orthopedic shoes
With a moderate and severe course of pathology, it is necessary to prevent the deforming form of arthrosis. To do this, use:
- plaster casts;
- curative gymnastics;
- ultraviolet irradiation
- orthopedic products.
In cases of diagnosis of a complicated form of the disease, as well as in those situations when treatment of Blount’s disease at lighter stages of the course was not performed before the child was six years old, a surgical procedure is shown to the patient.
In such cases, it is necessary to treat the disease with:
- Ilizarov’s apparatus
- Corrective high tibial osteotomy. Less often resort to the lower osteotomy of the fibula;
- the establishment of bone allografts
- knee joint ligament plasty.
Prevention and Forecast
In order to avoid the possible development of Erlacher Blount’s disease, preventive measures should be performed by parents in relation to the child. Thus, prevention includes:
- control over body weight — it should not be above the norm;
- enriching the diet with vitamin D;
- making sure that the baby first starts to crawl and only then walk;
- Regularly be screened by all children’s specialists
The outcome of the disease is dictated by several factors:
- degree of deformation;
- presence or absence of disturbances of the growth plate
- early diagnosis;
- timely started complex therapy
- the timing of the surgical procedure
Often the child regains his normal legs and walking. Consequences in the form of disability are very rare.