Guided Growth Treatment for Early-Onset Blount Disease

A 3-year-11-month-old male with left-sided genu varum secondary to early-onset Blount disease underwent guided growth treatment using an extraperiosteal non-locking plate across the lateral proximal tibial growth plate. Fourteen months postoperatively, once slight valgus overcorrection of the left lower extremity was confirmed on full-length standing radiographs, the hardware was removed. At the latest follow-up 26 months postoperatively, symmetric alignment of both lower extremities was noted. Further follow-up will be needed to ensure that the limb alignment is maintained over the remaining years of skeletal growth. While there are reports of hardware failure and rebound growth in some patients with Blount disease, guided growth treatment is a viable alternative to a proximal tibial osteotomy in children with mild to moderate deformity who have sufficient growth remaining at the ipsilateral proximal medial tibial physis.