Blount's Disease: Signs, Causes, And How To Treat

Written by Medicover Team and Medically Reviewed by Dr Shashivardhan , Orthopedics

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Blount's disease, also known as tibia vara, is a condition that affects the growth of the shinbone, causing it to bend inward instead of growing straight. This can lead to changes in the alignment of the leg, affecting how a person stands and walks. The exact cause of Blount's disease is not fully understood, but it is believed to be related to factors such as excess weight, early walking or standing, genetics, and certain ethnicities being more prone to developing the condition.

The abnormal growth of the shinbone in Blount's disease can put extra stress on the knee joint and lead to other complications if not addressed. If you suspect your child may have Blount's disease, it is important to consult with a healthcare provider

What Are the Types of Blount's Disease?

Blount's disease is classified based on the age at which symptoms first appear. The different types vary in severity, progression, and treatment approach.

Infantile Blount's Disease: This is the most common type and develops in children younger than 4 years, usually between 1 and 3 years of age. It often affects both legs and causes progressive bowing of the legs.
Juvenile Blount's Disease: This type occurs in children between 4 and 10 years of age. It is less common than the infantile form and may affect one or both legs.
Adolescent Blount's Disease: This form develops after 10 years of age, typically during adolescence. It usually affects one leg and is strongly associated with obesity and rapid growth.

What Are the Symptoms of Blount's Disease?

The symptoms of Blount's disease vary depending on the child's age and the severity of the condition. The most noticeable feature is progressive bowing of one or both legs, which worsens over time instead of improving naturally.

Progressive bowing of one or both legs (bowlegs).
Bowing that becomes more pronounced after the age of 2 years.
Inward turning of the lower leg below the knee.
Uneven leg length in some individuals.
Knee pain or discomfort, especially in older children and adolescents.
Limping or an abnormal walking pattern.
Difficulty walking, running, or participating in physical activities.
Instability or reduced range of motion of the knee.
Abnormal stress on the knee joint, which may worsen with growth.
Waddling gait in children with involvement of both legs.

What Are the Causes of Blount's Disease?

The exact cause of Blount's disease is not fully understood. It is believed to result from abnormal growth of the growth plate (physis) at the upper part of the tibia (shinbone), leading to progressive bowing of the legs. Several factors may contribute to the development of the condition.

Abnormal growth of the growth plate on the inner side of the upper tibia.
Excessive stress on the growth plate due to early walking.
Obesity, which increases pressure on the developing leg bones.
Genetic predisposition or a family history of Blount's disease.
Rapid skeletal growth during childhood or adolescence.
Mechanical overload on the knee joint and lower leg.
Certain ethnic backgrounds, with a higher prevalence reported in some populations.

When to See a Doctor for Blount's Disease?

If you notice your child's legs bowing inward, particularly after age two, consult a pediatric orthopedist for a thorough assessment. Early diagnosis and treatment are essential to prevent permanent deformity, arthritis, and walking difficulties that can significantly impact your child's mobility and quality of life.

You should see a doctor if you have:

Progressive bowing of the legs that worsens over time or appears asymmetrical
Knee pain, limping, or difficulty walking in a child with bowed legs
One leg appears shorter than the other, or there are noticeable changes in gait pattern

Get medical help immediately if:

Sudden inability to bear weight on the leg with severe pain or swelling
Visible deformity after injury or trauma to an already bowed leg
Signs of infection, including fever, warmth, and redness around the knee joint

These could be signs of a serious complication like a fracture, which needs urgent care.

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How is Blount's Disease Diagnosed?

Blount's disease is diagnosed through a combination of medical history, physical examination, and imaging studies. Early diagnosis is essential to prevent worsening of the leg deformity and to guide appropriate treatment.

Medical history: The doctor asks about the child's age, walking history, symptoms, family history, and progression of leg bowing.
Physical examination: The legs are examined for bowing, knee alignment, leg length differences, gait abnormalities, and range of motion.
X-rays: Standing X-rays of the legs are the primary imaging test used to evaluate the shape of the tibia, growth plate abnormalities, and the severity of the deformity.
Angular measurements: The physician measures the angle of the leg deformity on X-rays to distinguish Blount's disease from normal physiologic bowing.
MRI scan: Magnetic resonance imaging (MRI) may be recommended in selected cases to assess the growth plate, cartilage, and surrounding soft tissues, especially in early-stage disease.
CT scan (rarely needed): A CT scan may be used for surgical planning or to evaluate complex bone deformities.

What is the Treatment for Blount's Disease?

The treatment for Blount's disease depends on the child's age, the severity of the leg deformity, and the stage of the condition. Early treatment helps prevent progressive bowing and long-term complications affecting the knees and legs.

Bracing

Bracing may be recommended for young children, particularly those under 3 years of age with mild to moderate infantile Blount's disease. A knee-ankle-foot orthosis (KAFO) helps guide normal bone growth and improve leg alignment.

Surgery

Surgery is often required when the deformity is severe, progresses despite bracing, or is diagnosed in older children and adolescents.

Tibial osteotomy: The tibia is surgically cut and realigned to correct the bowing.
Growth modulation (guided growth): Small plates or screws are placed near the growth plate to gradually correct leg alignment as the child grows.
External fixation: An external frame may be used to gradually straighten the leg and correct complex deformities.
Corrective osteotomy with internal fixation: Plates and screws may be used to stabilize the bone after realignment.

Physical Therapy

Physical therapy is often recommended after surgery to improve muscle strength, restore joint movement, and help the child return to normal activities.

Weight Management

Maintaining a healthy body weight is important, particularly in overweight or obese children, as excess weight places additional stress on the growth plates and knee joints.

Regular Follow-up

Children with Blount's disease require regular follow-up visits and imaging studies to monitor bone growth, assess treatment outcomes, and detect recurrence or progression of the deformity.

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What to Expect Recovery from Blount's Disease?

Recovery from Blount's disease depends on the child's age, the severity of the deformity, and the type of treatment received. Children diagnosed and treated early generally have better outcomes, with improved leg alignment and normal growth. Recovery may take several months, especially after surgery, and requires regular follow-up to monitor bone growth and healing.

After treatment, healthcare providers assess the child's walking pattern, leg alignment, and growth to ensure the condition does not recur. Physical therapy and lifestyle modifications play an important role in restoring mobility and strength.

Mild cases treated early with bracing may show improvement within a few months.
Recovery after surgery typically takes several months, depending on the procedure performed.
Physical therapy helps improve muscle strength, flexibility, balance, and walking ability.
Weight-bearing activities may be limited initially after surgery and gradually increased as healing progresses.
Regular follow-up appointments and X-rays are necessary to monitor bone healing and leg alignment.
Children who maintain a healthy body weight place less stress on the healing bones and joints.
Most children can gradually return to normal daily activities and sports after complete healing and with their doctor's approval.
In some cases, additional procedures may be required if the deformity recurs or if growth plate abnormalities persist.