Blounts

Disease

ADVISORS :
dr. Rangga Arieza
dr. Denal Bato Tampak
dr. Herbert Yurianto
SUPERVISOR :
Dr. Notinas Horas Sp.OT

Yuka Purbani_Nurul Aqilah_Eka Novryanti_Noraine

_Nur Ikhwaini_Raswijayanti R

DEFINITION
Progressive

bow-leg deformity associated with abnormal

growth of the posteromedial part of the proximal tibia.
Blount characterized the deformity as an abrupt angulation just
below the proximal physis
An irregular physeal line and a wedge-shaped epiphysis with a
beak at the medial metaphysis.
Apparent lateral subluxation of the proximal end of the tibia is
often present.

Miller MD, Brinker MR. Pediatric Orthopaedics. 3rd Ed. Review of Orthopaedics; 2006.
John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 th edition; Elsevier Saunders;

ETIOLOGY

Miller MD, Brinker MR. Pediatric Orthopaedics. 3rd Ed. Review of Orthopaedics; 2006.
John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 th edition; Elsevier Saunders;

ANATOMY

Netters Concise Orthopaedic Anatomy, 2nd Edition, Chapter, Leg/Knee

PHYSIOLOGY
Normal children show
maximal varus at 6 to
12 months of age
Neutral alignment by
18 to 24 months
Maximal genu valgum at
4 years
Gradual decrease in genu
valgum age of 11 years
John Anthony Herring, MD. Chapter 22:
Disorder of the Leg. In: Tachdjian's Pediatric
Orthopaedics 4th edition; Elsevier Saunders;
2008

Development of the tibiofemoral angle during growth.Salenius&Vankka Graph

Normal transition from varus alignment at

Evolution of lower limb alignment from varus to
14 months to neutral position at 25
valgus to normal alignment.
months to valgus tibiofemoral alignment
at 39 months
John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 edition; Elsevier Saunders
th

PATHOPHYSIOLOGY

John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 th edition; Elsevier Saunders;

ANAMNESIS

John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 th edition; Elsevier Saunders;

PHYSICAL EXAMINATION
John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 th edition; Elsevier Saunders;

Physical Appearance

Blounts Disease is characterized the deformity as an abrupt angulation just below the proximal
physis
Netters Concise Orthopaedic Anatomy, 2nd Edition, Chapter, Leg/Knee

Langenskiold classification
based on the degree of
metaphyseal-epiphyseal changes

RADIOGRAPHIC FINDINGS
Tibiofemoral angle
(TFA) >20
Tibial metaphyseal
diaphyseal angle
(MDA) > 11

Abrupt angulation at the epiphyseal

metaphyseal junction and medial
metaphyseal radiolucency and
beaking.

John Anthony Herring, MD. Chapter 22:

Disorder of the Leg. In: Tachdjian's Pediatric
Orthopaedics 4th edition; Elsevier Saunders;
2008

MANAGEMENT

PROGNOSIS

DIFFERENTIAL
DIAGNOSIS

John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 th edition; Elsevier Saunders; 2008

COMPLICATIONS

John Anthony Herring, MD. Chapter 22: Disorder of the Leg. In: Tachdjian's Pediatric Orthopaedics 4 th edition; Elsevier Saunders; 2008

THANK YOU

1. Hukum Heuter-Volkmann Pengaruh tekanan (pressure) pada

GP : pressure bertambah, pertumbuhan akan terlambat
2. Hukum Delpech ; pengaruh tarikan (distraksi) pada GP:
distraksi merangsanGgP menyebabkan percepatan
pertumbuhan Hubungan G.Pd engan pressurep ada G.P :
pressure bertambah, pertumbuhan akan terhambat (pelan).
Pressure berkurang (distrakspie) rtumbuhan bertambah. Gaya
(stress) yang tidak simetri pada G.Pm enyebabkan angulassi,t
ress torsi (torque) paralepla da G.P menyebabkan deformitatosr
sional
3. Hukum dari Wolff Hukum Wolff sering disingkat 3F : Form
Follows Function. Perubahan-perubabentuk dan stress pada
tulangd iikuti oleh perubahan- perubahan internal (arsitektur)
dan bentuk (form) eksternal, sesuaid engan mathematicrualle
s.