%0 Journal Article
%T Severe Infantile BlountĄ¯s Disease in Kumasi, Ghana: A Case Report - Severe Infantile BlountĄ¯s Disease in Kumasi, Ghana: A Case Report - Open Access Pub
%A Adu-Osei
%A Ampem Darkwa
%A Banahene
%A Dominic Konadu-Yeboah
%A Peter Konadu
%J OAP | Home | Journal of Preventive Medicine And Care | Open Access Pub
%D 2018
%X BlountĄ¯s disease, also known as tibia vara, is a developmental disorder involving the posteromedial proximal tibial physis resulting in progressive varus, procurvatum and internal torsion of the affected tibia 1. The condition was first published by Blount in 1973 2. The aetiology of this disease is unkown. However, associations exist between blountĄ¯s disease and the Afro-Caribbean race, early age of walking and obesity 3, 4. Furthermore, genetic predisposition has been postulated as well as mechanical loading of the physis 4, 5, 6. Affected children are usually overweight and start walking early. It is bilateral in 80% of cases 7. DOI10.14302/issn.2474-3585.jpmc-19-3009 BlountĄ¯s disease, also known as tibia vara, is a developmental disorder involving the posteromedial proximal tibial physis resulting in progressive varus, procurvatum and internal torsion of the affected tibia 1. The condition was first published by Blount in 1973 2. The aetiology of this disease is unkown. However, associations exist between blountĄ¯s disease and the Afro-Caribbean race, early age of walking and obesity 3, 4. Furthermore, genetic predisposition has been postulated as well as mechanical loading of the physis. 4, 5, 6 Affected children are usually overweight and start walking early. The role of weight bearing in the pathogenesis of tibia vara was demonstrated in a study by Cook and others 5 who concluded that weight bearing was necessary for the disease to occur, since it is almost never diagnosed before 2 years of age. The disease often manifests after at least 1 year of walking and is never encountered in non-ambulatory children. BlountĄ¯s disease is a progressive disorder which if left untreated leads to premature physeal arrest at the proximal posteromedial tibia with a resultant varus deformity of the proximal tibia. 16. It is bilateral in 80% of cases 7 and a cause of significant knee pain and activity limitation among affected children and adolescents. Pathology Tibia vara is a disease that involves the epiphysis, physis and the metaphysis 3, 8, 9. Disruption of the normal enchondral ossification in the posteromedial aspect of the proximal metaphysis occurs with defective growth of the posteromedial physis 10, 11. The disruption of growth at the proximal medial tibial physis occurs due to abnormal stresses on the epiphysis in response to the Heuter-Volkman law which states that increased pressure on an epiphysis inhibits growth 5. This concept is reinforced by DelpechĄ¯s law which says stimulation of epiphyseal growth occurs by release of pressure 5. It therefore
%U https://www.openaccesspub.org/jpmc/article/1168