• Littrell TA
• Heston JR

• Adolescent
• Athletes
• Genu Varum
• Male
• Open Access Document

Objective: The purpose of this case report is to describe the clinical presentation, radiographic evaluation, physiological and pathological differentials, and surgical management of progressive symptomatic tibia vara (Blount disease).

Clinical Features: A 13-year-old male sought evaluation and care for knee pain at an outpatient chiropractic clinic. The chiropractor identified varus bowing of the involved leg and exaggerated lateral movement at the knee in the heel strike phase of the patient’s gait. Radiographic evaluation revealed a medial proximal tibial slope, increased metaphyseal-diaphyseal angle, and metaphyseal beaking of the involved leg, consistent with Blount disease.

Intervention and Outcome: The patient was evaluated in two orthopedic clinics for management of Blount disease. An outpatient surgical intervention with tension-band plating was performed to arrest lateral tibial growth. The patient was weight-bearing at the time of release, with minimal pain management interventions, and with few activity restrictions.

Conclusion: Physiological tibia vara is common in young children and must be differentiated from pathological tibia vara by clinicians and radiologists through assessment of risk factors, clinical presentation, radiographic assessment, and monitoring of progression. Early detection and treatment of pathological tibia vara is essential to limit the progression and subsequent complications of undetected or untreated Blount disease.

Author keywords: Blount Disease, Tibia Vara, Bowed Legs, Lateral Thrust, Osteotomy, Epiphysiodesis, Metaphyseal Beak

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