The Surgical Treatment and Outcome of Blount Disease in a Tertiary Hospital: A 10-years Review

Abstract

Blount disease is an uncommon condition in Malaysia. The prevalence has not been documented and to the best of our knowledge, there are no local studies published on this condition. This is a retrospective study carried out in the Department of Orthopedics and Traumatology, Hospital University Kebangsaan Malaysia. Fifteen patients participated in this study, 12 of them had bilateral knee involvement. All patients had an oblique osteotomy of the proximal tibia without an elevating osteotomy of the medial tibial plateau. The objective of this study was to examine the clinical outcome for the surgical treatment of Blount disease in our institution from 1997 to 2008 by measurements of metaphyseal –diaphyseal angles (MDA) and tibio-femoral angles (TFA) preoperative, postoperative and during follow up. The study showed statistically significant reduction in the mean metaphyseal – diaphyseal angles (MDA) and mean tibio-femoral angle (TFA) angles respectively post operatively compared to pre-operatively (p < 0.001).Recurrence of the deformity was noted in 10 knees. All of them underwent further surgery .The mean postoperative follow up is 4.9 years. Half of the cases were Langenskiold stage III. One patient developed gas gangrene post operatively (3.8%) and another patient had wound dehiscence (3.8%). Conclusion: An oblique osteotomy of the proximal tibia without an elevating osteotomy for the improves the clinical and radiological outcome for our patients. However, one patient developed gas gangrene – an extremely rare complication following a clean surgical procedure.