Osteotomy treatments and post-operative fixations for Blount disease: A systematic review

Background: Blount disease is a developmental abnormality characterized by abnormal ossification of proximal tibia, resulting in lower limb deformities with tibia vara. The condition worsens into knee deformity, gait abnormalities, and premature medial compartment osteoarthritis if left untreated. Managements of those deformities have also advanced in line with the understanding of the deformities. Without proper care management, they could lead into residual and translational deformities, increase of recurrence, and complicate the revision surgery. Methods: This study aims to enrich our understanding about the recent advances of treatments for Blount disease by reviewing 15 articles published with osteotomy surgeries and fixation methods. We also highlight many aspects of pre-operative assessment and planning, post-operative complications and recurrence, patients' follow-up, and overall satisfaction from patients’ self-assessment. Results: The scope of this review is considered small but still covers various efforts to manage Blount diseases, including single-stage double osteotomy, grafting fibular fragments into tibia, two comparison studies, two unique case study, and experimental techniques to manage special cases requiring novel procedures. Conclusion: Careful surgical planning, acute or gradual correction options, and the use of fixator should be tailored to individual cases.