Blount's Disease

Blount’s Disease

Blount’s disease is a growth disorder that affects the shinbone (tibia) and causes the leg to curve outward, creating a bowlegged appearance. It occurs when the growth plate on the inside of the knee fails to grow normally. Blount’s disease can affect one or both legs and may worsen as a child grows. With early diagnosis and proper treatment, most children can achieve good leg alignment and return to normal activities.

What Causes Blount’s Disease?

Blount’s disease occurs when growth in part of the tibia slows or stops, leading to uneven bone development. Factors that may increase risk include:

• Early walking or heavy weight on the legs at a young age
• Rapid growth
• Excess body weight, which increases stress on the growth plate
• Family history of bone or growth disorders
• Certain biomechanical or alignment differences

There are two main forms:

• Infantile Blount’s disease, which begins before age 4
• Adolescent Blount’s disease, which begins in older children and teens

What Are the Symptoms?

Symptoms of Blount’s disease include:

• Bowing of one or both legs that does not improve with age
• Uneven leg length in some cases
• Knee pain or discomfort, especially with activity
• An awkward or uneven walking pattern
• Worsening bowing as your child grows

Unlike normal bowlegs in toddlers, Blount’s disease does not correct itself over time.

When Should My Child See a Specialist?

You should consider seeing a pediatric orthopedic specialist if:

• Your child’s legs remain bowed after age 2–3
• The bowing appears to be getting worse
• Only one leg is affected
• Your child has knee pain or difficulty walking
• Your pediatrician expresses concern about leg alignment

Early evaluation is important to prevent progression and long-term joint problems.

How Is Blount’s Disease Diagnosed?

Diagnosis begins with a physical exam and a review of your child’s growth and walking pattern. Imaging studies may include:

• X-rays to evaluate the shape and growth of the tibia
• Measurement of leg alignment and growth plate changes

These images help confirm the diagnosis and determine severity.

How Is Blount’s Disease Treated?

Treatment depends on several factors, including:

• Your child’s age
• Severity of the bowing
• Stage of growth
• Whether one or both legs are affected

Treatment goals focus on:

• Correcting leg alignment
• Supporting healthy bone growth
• Preventing joint damage
• Improving walking and comfort

Nonsurgical Options

For young children with mild to moderate disease, treatment may include:

• Bracing to guide bone growth and improve alignment
• Regular follow-up visits and imaging
• Activity and weight management guidance

Bracing is most effective when started early, before the bones have matured.

Surgical Options

Surgery may be recommended if bracing is not effective or if Blount’s disease is diagnosed later. Surgical options may include:

• Growth modulation, which guides bone growth over time
• Osteotomy, where the bone is cut and realigned
• Internal fixation to hold the corrected position

Your child’s surgeon will help you choose the safest and most effective approach.

What Are the Risks of Surgery?

When surgery is needed, possible risks may include:

• Infection
• Problems with bone healing
• Need for additional procedures
• Leg length differences
• Nerve or blood vessel injury (rare)

All risks will be carefully discussed with your child’s care team.

What Does Recovery From Treatment Involve?

Recovery depends on whether treatment is nonsurgical or surgical. Children treated with braces can often continue normal activities with some adjustments. After surgery, your child may need:

• A period of limited weight-bearing
• Physical therapy to restore strength and movement
• Follow-up visits to monitor healing and growth

How Long Does Recovery Take?

With bracing, improvement happens gradually over months. After surgery, initial recovery usually takes 6–8 weeks, with full return to activity over several months, depending on the procedure.

What Is the Outlook for My Child?

The outlook for children with Blount’s disease is very good when diagnosed early. With proper treatment and follow-up, most children achieve good leg alignment and remain active without long-term problems.