BLOUNT DISEASE

Blounts disease

-varus
-valgus
-recurvatum
-planus

ANATOMI

ANATOMI

F
Predisposisi
Tinjauan
Pustaka

Genetik

Ras
Umur mulai
berjalan
Obesitas

Epidemiolog
i
Infantil (1-3 tahun)

Juvenil (4-10 tahun)

Adolesence ( 11
tahun)

Prinsip HeuterVolkmann

PATOFISIOL
OGI Obesitas

Tekanan yang
berlebih pada
bagian
medial
epifisis

Gangguan
struktur dan
fungsi kondrosit ,
menghambat
osifikasi dari
epifisis

MANIFESTA
SI KLINIS

Pemeriksa
an Fisik
dan
Penunjang

Pemeriksaan Fisik

Deformitas varus
Torsi Interna Tibia
Diskrepansi panjang kaki
Nyeri Pada Sisi Medial Lutut

Pemeriksaan Penunjang
Angulasi varus dari metafisis
Pelebaran dan iregularitas dari
aspek medial lempeng
pertumbuhan
Osifikasi irregular pada epifisis
Bentuk paruh (beak) pada
bagian medial epifisis

Langenskiol
d Staging

3. Valgus overcorrection: 5-100 of valgus overcorrection

decreases the chanceof recurrence.

b.
Guided growth
Guided growth with a non-locking titanium plate with
screws placed extraperiosteally across the convex growth plate
was popularised by Stevens. This plate with two screws, one
in the metaphysis and the other in the epiphysis, serves to

Physeal bar excision and interpostion of fat has been

tried along with osteotomy in the advanced stages of the
disease. Long term results are not well documented

f.
Elevation of the medial plateau
Elevation of the medial plateau by intra epiphyseal or
trans epiphyseal osteotomy has been attempted in late stages
of disease.The metaphyseal osteotomy, with or without

Age
(Years)

Langenskiold stage
1, 2

Treatment

<4

Bracing

>4

Proximal metphyseal osteotomy

>4

Proximal metphyseal osteotomy with or without

derotation

4, 5

< 10

Intra epiphyseal osteotomy with proximal

metphyseal osteotomy

4, 6

> 10

Inter epiphyseal osteotomy with proximal

metphyseal osteotomy

Penatalaksa
1, 2
naan
3

Upper tibial & fbular epiphyseodesis + Proximal

metaphyseal osteotomy+ limb lengthening

Multiple recurrences

Table 1. Outline of treatment of Blounts disease

TS, Gopakumar. Tibia Vara (Blounts Disease). Kerala Journal of orthopaedics 2014; 65:68.

Kerala Journal of Orthopaedics Volume 27 | Issue 1 | January 2014

67

Pengobatan Non-Operatif

PENGO
BATAN
OPERA
TIF

KOMPLIKASIDeviasi

Gaya
Berjalan

Diskrepan
si
panjang
Ekstremit
as

Artritis
dini sendi
lutut

PEMERIKSAAN RADIOLOGI

B : Sudut Metaphyseal Diaphyseal 45

FOTO PRE
OPERASI

Foto
Post
Operasi
(18/8/2
014)

FOTO X-RAY
POST OPERASI

TERIMA KASIH