Femoral torsion in patients with Blount’s disease

Abstract

In 1937 Blount described a series of 28 patients with 'Tibia vara'. Since then, a number of deformities in the tibia and the femur have been described in association with this condition. We analysed 14 children with Blount's disease who were entered into a cross-sectional study. Their mean age was 10 (2 to 18). They underwent a clinical assessment of the rotational profile of their legs and a CT assessment of the angle of anteversion of their hips (femoral version). We compared our results to previously published controls. A statistically significant increase in femoral anteversion was noted in the affected legs, with on average the femurs in patients with Blount's disease being 26 degrees more anteverted than those in previously published controls. We believe this to be a previously unrecognised component of Blount's disease, and that the marked intoeing seen in the disease may be partly caused by internal femoral version, in addition to the well-recognised internal tibial version.

Femoral anteversion: significance and measurement

“…In addition, higher values are observed in children with a range of disorders affecting skeletal development. For example, Blount's disease causing bowing of the tibia (Aird et al, 2009), Legg‐Calvé‐Perthes disease resulting in avascular necrosis of the femoral head (Lerch et al, 2018) and achondroplasia (Song et al, 2006), which results in substantially reduced limb length. On the other hand, obesity in adolescence is associated with an FNA of only 0.4° ± 13° (Galbraith et al, 1987).…”

Osteotomy for deformities in blount disease: A systematic review

“…Thirteen articles were retrieved for further evaluation. [4][5][6][7][8][9][10][11][12][13][14][15][16] Of these articles, only four articles fitted the study criteria. [4][5][6][7] They were summarized in Table 1.…”

The Lower Extremity: Acquired Disorders

“…Internal tibial torsion is a common component of the deformity. Femoral anteversion is also often increased; there is some evidence that this represents a response to therapeutic intervention [ 26 ]. In cases of mild late-onset tibia vara, MRI fi ndings are limited to the medial aspect of the proximal tibial growth plate, which appears wide and irregular.…”