Re: Blounts Disease

Re: Blounts Disease

Donald E. Katz, C.O.

1/27/1999

You hit the nail on the head, Bill, with respect to the importance of
differentiating true Blount's disease from physiologic genu varum.
That is, of course, in recognition that physiologic bowing (assuming
it doesn't progress to demonstrating a true Blount's like lesion on the
proximal, medial tibial epiphysis) will spontaneously resolve without
treatment. A Langenskiold I is almost impossible to accurately
differentiate from physiologic bowing on a standing radiograph.
Other reviews have included Langenskiold I cases, thus there's a risk
of bias to a positive outcome with respect to conservative
(orthotic) treatment, as not all were destined to demonstrate a
continued progression of their tibial deformity.
For that very reason, we limited our review to children with a
Langenskiold II or III involvement.
Thanks for the feedback.
-Don Katz, C.O.

From: William J. Barringer < <Email Address Redacted> >
To: <Email Address Redacted> < <Email Address Redacted> >
Subject: RE: Blounts Disease
Date: Wed, 27 Jan 1999 13:51:37 -0600

DON WE SEE MANY BLOUNT'S PTS. ALTHOUGH I HAVE NOT READ YOUR ARTICLE YET WE
ARE STRUGGLE WITH THE TRUE DIAGNOSIS OF , IS THIS REALLY BLOUNT'S OR
PHSIOLOGICAL. WE USE A MEDIAL KEEN JOINT WITH LOCK, FREE ANKLE, AND A STRAP
TO PLACE A VALGUSMOMENT ON THE SITE. WE HAVE NOT REVIEWED OUR PTS YET BUT
WILL PROBABLY DO SO IN THE FUTURE. BILL BARRINGER

-----Original Message-----
From: Donald E. Katz, C.O. [mailto:<Email Address Redacted>]
Sent: Wednesday, January 27, 1999 5:46 AM
To: <Email Address Redacted>
Subject: Re: Blounts Disease


We recently had our research published in the Journal of Pediatric
Orthopaedics. Volume 18:374-380, 1998. BS Richards, M.D., DE Katz,
C.O., JB Sims, M.D. The Effectiveness of Brace Treatment in Early
Infantile Blount's Disease.
In this, we studied the efficacy of using a medial upright only,
elastic corrective strap KAFO (as well as some patients treated with
conventional [metal and leather] KAFO's and HKAFO's). The elastic
KAFO design was first described by Terry Supan, CPO in:
Clinical Orthotics and Prosthetics
1985; 9:3-6.
Terry's article best describes the actual manufacturing of the
this orthosis.
We found it to be an effective treatment for true,
Infantile Tibia Vara (Blount's Disease), with cases of unilateral
involvment having a significantly higher treatment success rate than
those with bilateral involvment. The age range of our population in
this review was 1.5 - 3.2, average age being 2.1 years. Thus, our
review may be applicable to the child you are about to treat.
I hope this helps!
-Don Katz, C.O.
Director, Orthotics Department
Texas Scottish Rite Hospital for Children
Dallas, TX


Date: Wed, 27 Jan 1999 11:42:30 EST
Reply-to: <Email Address Redacted>
From: Eddie White < <Email Address Redacted> >
Subject: Blounts Disease
To: <Email Address Redacted>

Paient is a 2 year old that has been diagnosed with blounts disease,
searching for bracing ideas. Script reads single upright with free ankle and
knee pad .
            William Earles C.O.