Recently, doctors in young patients are increasingly diagnosed with various musculoskeletal disorders. The prevalence of pathologies of the musculoskeletal system over the past 10 years has increased 2.5 times. Among them, the second place after rickets is Blount's disease.
The pathology was first described by the Austrian orthopedist Erlacher in 1922. A little later, Blount expanded his understanding of this disease, calling the main clinical manifestation of deformity of the tibia. Its curvature in the upper part leads to a persistent violation of mobility in the knee joint. As a result, cartilage growth stops or stops altogether.
Causes and mechanism of the development of the disease
The exact causes of this disease are unknown. Doctors make several assumptions on this issue. Blount's disease can be caused by local chondrodysplasia, due to which the epiphyseal cartilage of the tibia is involved in the pathological process. These phenomena explain the presence of congenital anomalies in most of the examined patients, and also suggest a hereditary relationship.
The triggering mechanism for the pathological process is two factors: immaturity of the musculoskeletal system and anatomical defects in the structure of the lower extremities. With varus production of the lower leg, the patient has an overstrain of the external or internal condyle. As a result, the pineal gland enlarges, assumes a deliberately incorrect position and shifts. Excessive pressure not only bones, but also muscle tissue. As the pathological process develops, the situation only worsens - the cartilage tissue is more slowly transformed into bone and cannot withstand such a load that a healthy person can handle.
Among the factors predisposing to the disease, the following can be distinguished:
- overweight;
- disorders of the endocrine system;
- congenital defects of the tibia.
Among other reasons, it is also necessary to note a deficiency of vitamin D. With a lack of it or a violation of digestibility, a mutation may occur in the body, which as a result leads to the development of the disease.
Symptoms and first manifestations
Blount's disease in children occurs from the first days of life, but begins to manifest itself only by the age of two. Initially, parents notice a slight curvature in the lower legs. In the future, this process is only exacerbated. The child cannot stand for a long time, constantly trying to sit down or hold on to a support. Already at this stage, the baby begins to limp, he has a characteristic duck gait (transfer from one foot to another). The magnitude of the curvature of the lower leg can vary from 20 to 80 degrees.
The lack of proper treatment leads to a violation of the proportions in the size of the limbs. The legs are noticeably shortened, and the arms against their background seem excessively long. Sometimes the fingers of the hands reach the knees. Against the background of such changes in patients, flatfoot appears, the tone of the lower leg muscles decreases .
Medical Examination and Diagnostics
What to do if you suspect Blount's disease? Photos of the manifestations of the pathological process help many parents to identify violations at an early stage. To confirm the diagnosis, consultation with an orthopedist is necessary. It is enough for a specialist to inspect the child and conduct a simple test. The baby is asked to reduce the legs, after which the distance between the limbs is estimated. If it is more than 5 cm, the child is not sent an x-ray to obtain a complete clinical picture. With the development of complications (various pathologies of cartilage or bone tissue), MRI and CT may be required. According to the results of the examination, the doctor refutes or confirms the diagnosis of “Blount disease”.
Home treatment
Self-treatment of Blount's disease is not welcome, you should definitely contact an orthopedist. The choice of treatment method depends on the stage of the pathological process, the age of the patient and the individual characteristics of the body. At the initial stage, physiotherapy exercises and a special massage to correct deviations show excellent results. The complex of exercise therapy includes corrective poses. Exercises can be performed at home after they are prescribed by a doctor. With severe flat feet, the child should wear orthopedic shoes. A diet rich in minerals and vitamins is also shown. Mud applications and sea baths are recommended for all young patients, regardless of what stage Blount's disease is at. Treatment with drugs to stimulate muscle activity is not always justified.
Surgical intervention
Surgery is indicated for those patients in whom conservative methods of therapy did not bring the desired results. As a rule, these are children 3-6 years old. Surgical intervention involves the excision of fragments of the tibia with the obligatory imposition of the Ilizarov apparatus. The operated elements are fastened with plates and screws; sometimes it is advisable to use external metal frames.
In the postoperative period, further observation by an orthopedic surgeon is required. The specialist should choose a rehabilitation program for the patient. The recovery period usually takes up to two years. With its successful implementation, patients quickly adapt to their usual way of life.
Preventive measures
How to prevent Blount's disease? Doctors recommend that from the first months of the baby's life, control his weight. Overweight often leads to bone deformation. You should not rush the child so that he starts walking as soon as possible. Muscles of children develop sequentially. First, they strengthen, and the baby begins to roll on its stomach, then sit and crawl, and only after that take the first steps.
Pediatricians recommend giving him vitamin D during the first 12 months of a child’s life, because he is responsible for strengthening the bone apparatus. At the age of 1 year, the baby must go through certain doctors. Be sure to visit the orthopedist, even if there are no visible violations. Not all parents listen to the advice of doctors, so Blount's disease, the causes of which are described above, is not uncommon today. However, early diagnosis and proper treatment increase the chances of a speedy recovery.