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      Enfermedad de Blount: a propósito de un caso Translated title: Blount disease: a case report

      case-report

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          Abstract

          Resumen: La enfermedad de Blount o tibia vara es una alteración del desarrollo que afecta al cartílago de crecimiento proximal de la tibia. Es una entidad poco frecuente y de probable origen multifactorial, cuya etiología no está aclarada. Provoca una deformidad progresiva con un arqueamiento de las extremidades inferiores en forma de genu varo. En la variante precoz es más frecuente la afectación bilateral por lo que en los casos leves puede ser difícil diferenciar del genu varo fisiológico. Presentamos el caso de una niña de 15 meses de origen africano que presenta un genu varo bilateral progresivo. Tras un seguimiento clínico y radiológico precisó finalmente corrección quirúrgica de la deformidad.

          Translated abstract

          Abstract: Blount disease is a developmental disorder that affects the proximal growth cartilage of the tibia. It is a rare entity of probable multifactorial origin whose etiology is not clear. It causes a progressive deformity with a bowing of the lower limbs in the form of a genu varum . In the early variant, bilateral involvement is more frequent, so in mild cases it may be difficult to differentiate between the physiological variant. We present the case of a 15-month-old girl of African origin, who has a progressive bilateral genu varum . After a clinical and radiological follow-up, he finally needed surgical correction of the deformity.

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          Most cited references3

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          Blount disease.

          John Birch (2013)
          In 1937, Blount described progressive tibial varus deformity observed in otherwise healthy children and adolescents. Although he called the condition "osteochondrosis deformans tibiae," the disorder is most frequently referred to as Blount disease. Two distinct clinical and radiographic forms have been recognized: infantile and adolescent. A third form, which was called "juvenile" Blount disease by Thompson, is recognized by some authors and is intermediate in severity and age of onset. The etiology of Blount disease is unknown. If the condition remains unresolved, it can lead to progressive varus deformity, with or without associated deformities of the distal femur and/or tibia; leg length inequality; and significant articular distortion, leading to premature osteoarthritis of the knee. A strong, but not universal, association exists between Blount disease and childhood obesity, increasing the prevalence and making effective treatment of this condition a challenge. Infantile Blount disease may resolve, respond to nonsurgical treatment, or be relentlessly progressive, so the surgeon must be astute in recognizing the features of true infantile Blount disease to determine effective treatment options.
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            Blount disease: an update.

            Blount disease is a developmental disorder associated with childhood obesity. Based on whether the deformity is first noted before or after 4 years of age, early-onset and late-onset forms of Blount disease have been described. Besides physeal abnormalities of the proximal tibia, compensatory changes in the intra-articular morphology of the medial compartment of the affected knee are often noted on MRI scan. Both guided growth and acute and gradual correction via a proximal tibial osteotomy have roles in the surgical management of these patients. In order to optimize clinical outcome, frequent follow-up until skeletal maturity is recommended.
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              Are patient demographics different for early-onset and late-onset Blount disease? Results based on meta-analysis.

              Early-onset and late-onset Blount disease has been described with some clinical overlap between the two forms. Using PRISMA guidelines, we searched for articles that included demographics of patients with both types of Blount disease. On the basis of 24 articles that met our inclusion criteria, patients with early-onset Blount disease were more likely to have bilateral involvement [odds ratio (OR) 4.30, 95% confidence interval (CI) 2.27-8.17] and less likely to be Black (OR 0.20, 95% CI 0.08-0.53) or male (OR 0.32, 95% CI 0.13-0.78). Our results confirm that differences based on laterality, race, and sex exist between the two forms of Blount disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                June 2017
                : 19
                : 74
                : 167-169
                Affiliations
                [1] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Urgencias Extrahospitalarias Spain
                [6] Pamplona Navarra orgnameComplejo Hospitalario de Navarra orgdiv1Servicio de Traumatología España
                [4] Pamplona Navarra orgnameCentro de Salud Rochapea España
                [2] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Urgencias Extrahospitalarias Spain
                [3] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Urgencias Extrahospitalarias Spain
                [5] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Urgencias Extrahospitalarias Spain
                Article
                S1139-76322017000200014
                c7d177c6-9d2f-4f05-9852-02a47c00622e

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 3, Pages: 3
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                SciELO Spain


                Tibia vara,Blount disease.,Obesidad,Genu varum,Enfermedad de Blount.,Obesity

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