Case 63: Infantile Blount Disease with Plateau Depression

Abstract

Infantile Blount disease is challenging to treat. In young patients, brace treatment is controversial but may be worthwhile; guided growth by staples or plate may be successful, but historically, treatment has been prefer by osteotomy. Recurrence implies that the disease has been complicated by growth plate arrest or dysfunction and this aspect has to be addressed; otherwise, there will be further inexorable recurrence. The deformity may be a combination of the disease process and also postsurgical deformity from any previous procedures Fig. 1. It is particularly important to recognize medial hemiplateau deformities from those that involve the entire plateau as the management should be different. Those that only or largely involve the medial plateau require some form of hemiplateau elevation as part of the management, whereas whole plateau involvement requires reorientation of the entire plateau. Provided translation is respected; the whole plateau type is relatively easily corrected by a Taylor Spatial Frame with a metaphyseal osteotomy. Unfortunately most cases of recurrence are of the medial plateau type similar to this case.