Controversies in Blount’s Disease

Since the description of childhood (“infantile”) and adolescent idiopathic (usually) progressive varus deformity of the proximal tibia by Blount in 1937 and Langenskiöld in 1952, relatively little progress has been made to understand the etiology of either condition. Although both forms are often referred to as (infantile and adolescent) Blount’s disease, the conditions share little except for varus deformity of the proximal tibia. Radiographic appearance, the extent of epiphyseal and physeal distortion, secondary and adaptive radiographic deformities, short- and long-term natural history, and conservative and surgical treatment options may differ distinctly between the two conditions. The one current clinical feature that they often share is patient obesity, which complicates treatment, if not actually causes or accelerates the primary deformity. In this chapter, we review the radiographic and clinical features of both conditions, their natural histories, and advances and current options and controversies in conservative and surgical management of infantile and adolescent Blount’s disease.