Does your little one have bowed legs? Let's learn about Blount's Disease!

Moms and Dads, have you ever noticed that when your little one starts walking, or when they run and play, their legs bend inward, like the letter "C"? It's normal for babies to have slightly bowed legs. But, it doesn't always happen that way. Sometimes, this could be a condition called Blount's Disease , which is something to be concerned about. So today, we're going to talk about it in detail, as if a friend of yours were telling you about it.

What exactly is Blount's Disease?

Simply put, Blount's disease is a condition that affects the growth of the tibia , the thick bone below the knee, in children. It is also called tibia vara . At the ends of our bones are special parts called growth plates . Those plates are what make our bones grow, and we grow taller. In Blount's disease, the growth plate on the inside of the tibia doesn't grow properly. Then the leg starts to bend inward and become crooked.

It is normal for young babies, especially up to about a year old, to have slightly bowed legs (we call them "ball legs"). When they start walking, this bowing gradually disappears and their legs straighten out around the age of two. However, a child with Blount's disease does not lose this bowing in their legs. It may become more pronounced as the child grows.

What is the difference between normal bowing of the legs and Blount's disease?

Although these two may seem the same at first glance, there is a big difference.

• Physiological Bowing: This is very common in young babies. Once they start walking, usually around the age of two, this bowing of the legs will straighten out on its own . This does not require any special treatment.
• Blount's Disease: This is a condition where the leg below the knee bends inward . This bend is very pronounced. This does not get better on its own as the child grows, and can even get worse .

Now you understand the difference, right? There's no need to be afraid of a small child's slightly crooked legs. But if it persists, or seems to be getting worse, you should definitely see a doctor.

Who can develop Blount's disease? Who is at higher risk?

Although any child can develop Blount's disease, some people are at higher risk.

• Age: Symptoms usually appear in children over one year of age, usually between the ages of 1 and 3. This is called early-onset Blount's . Sometimes, the disease can appear in adolescence or even later in life. This is called late-onset Blount's .
• Body weight: Children who are overweight , or who gain weight quickly, are at higher risk of developing this disease.
• Walking too early: Some studies have found that children who start walking before 12 months are also at risk.

But remember, Blount's disease is a very rare disease . It is reported to affect less than 1% of the population.

How does Blount's disease affect a child's body?

This condition causes the child's shin bone (tibia) to not develop properly, causing the leg to bend inward. Instead of the toes pointing straight forward, they turn inward. The leg becomes curved like the letter "C".

If this is not treated properly, the condition can get worse.

• The curvature of the leg may increase, making it impossible to walk .
• It may be difficult to do things like play and exercise that involve using your legs.
• Nerve damage can occur in the legs.
• Conditions such as arthritis in the knee can cause pain.

Imagine, your little one loves to run and jump and play, but this difference in their legs prevents them from doing so freely. How sad is that? That's why it's important to be aware of this and take action quickly.

What are the symptoms of Blount's disease?

The main symptom is a bowing of the leg below the knee . Other symptoms include:

• The leg looks like it's bent inward like the letter "C".
• This bend can be in only one leg or in both legs.
• The toes and feet of the legs are turned inward instead of facing straight ahead.

Toddlers usually do not experience pain due to this bowed leg. However, adolescents may experience knee pain . This pain may increase, especially when playing, running, or jumping.

If the disease becomes severe, symptoms such as:

• Arthritis of the knee
• Difficulty walking
• Joint and nerve damage

What causes Blount's disease? Is it hereditary?

The exact cause of Blount's disease has not yet been discovered .

However, some studies show that, as mentioned earlier, this risk is higher in children who start walking before 12 months and in those who gain weight quickly at a young age.

Other studies suggest that it may be genetic . That is, it may be hereditary . The problem here is that the growth plates on the inside of the femur do not develop properly. A gene inherited from one's parents may cause a defect in these growth plates.

How does a doctor know for sure that this is Blount's disease?

If your child's legs are suspected to be bowed, the doctor will first do a thorough physical examination . Then, they will order an X-ray of the child's legs. This X-ray is usually taken from the ankle to the hip.

From X-ray images, the doctor can determine exactly how the child's bones are developing and what is causing the leg to bend inward.

This condition is usually diagnosed after the child is about two years old . This is because, as mentioned earlier, normal leg bending is normal by this age. If the leg curvature is still present after two years, the doctor will suspect Blount's disease and perform tests to confirm it.

What are the treatments for Blount's disease?

The treatment for Blount's disease is not the same for everyone. It varies depending on the age of the child and the severity of the disease . There are two main treatment methods.

1. Wearing a brace

This involves wearing a special brace, or brace , that extends from the child's thigh to the foot. This is often done for children under three years of age . This brace usually does not need to be worn all day long, but doctors recommend wearing it only at night while sleeping for about a year . This gradually straightens the leg.

2. Having surgery

Sometimes, especially if the child is over four years old or if the leg does not straighten properly even after wearing a brace, the doctor may recommend surgery .

This surgery is called an osteotomy . Simply put, it involves cutting the bone, straightening it, and fixing it. There are various methods used for this:

• Fixing the bone with staples or pins .
• Using a method called tension band plating .
• Straightening the leg by removing a piece of bone from the damaged shin bone (tibia) or adding a new piece of bone .

Although this surgery may seem like a big deal, it can be very important for the child's future and to properly repair the leg.

How to take care of a child after surgery?

It is very important to take care of your child after surgery.

• Keep the wound clean: You should always check the surgical site for infection . Clean the wound and apply medication as directed by your doctor.
• Do not put weight on the leg: It is not a good idea to put any weight on the leg that has undergone surgery for 6 to 8 weeks . If you put weight on it, the bone may not heal properly and may pull out again. Your doctor will tell you how long you should use crutches.

Is there a way to prevent this disease from developing?

Unfortunately, there is no definitive way to prevent Blount's disease.

However, there are a few things you can do to help your child's bones grow healthy and strong:

• Eat a well-balanced diet .
• Getting the child to exercise regularly .
• If necessary, give vitamin D or calcium as directed by a doctor.
• Maintaining a healthy weight appropriate for the child's age.

Remember, before giving your child any vitamins or other nutritional supplements, you should definitely consult a doctor to make sure it is safe.

What can I expect if my child has Blount's disease?

The prognosis for a child with Blount's disease depends on the child's age at diagnosis and the severity of the disease .

• Children under the age of four can expect a very good recovery if the disease is diagnosed early and treatment begins.
• However, if the disease is diagnosed late or not treated properly, the curvature of the leg can worsen, causing severe joint damage and making it difficult to walk .

After treatment, there is a small chance that the bowed legs will recur in young children and adults. However, if the disease is diagnosed and treated early, the risk is very low.

How long does Blount's disease last?

If this disease is not treated, it can last a lifetime and may even get worse as the child grows older.

After treatment, depending on the severity of the child's condition, either after the recovery period from surgery or after wearing a brace for about a year, the curvature of the leg will largely improve .

However, as mentioned earlier, there is a small risk of recurrence, so the doctor recommends that you take your child for regular checkups and check on the success of the treatment.

What time do you need to see a doctor?

If you notice these things about your child, definitely see a doctor:

• Even after the child starts walking, or after about two years , the curvature of the legs does not straighten on its own.
• If the child has pain along with crooked legs.
• If the child seems to have difficulty walking , or if he/she cannot put weight on his/her leg/legs.

What questions should you ask the doctor?

When you go to see the doctor, it's a good idea to ask some questions like these:

• How long will my child need to use crutches after surgery?
• Can my child play sports with this condition?
• If he has difficulty walking, does the doctor recommend that he use mobility assistance equipment ?
• If my child needs to wear a brace, when should they start wearing it and for how long?

Remember, it's normal for babies to have slightly bowed legs, and this will go away on its own once they start walking or around the age of two. However, if you notice that your child's legs are not straightening out, or that the bowing is getting worse, be sure to see a doctor. Early diagnosis and treatment can help stop the bowing from getting worse and prevent complications like arthritis.

Finally, a few things to remember

So, I hope you now have a better understanding of Blount's Disease, which we talked about today.

The most important thing is not to panic when you see a child's bowed legs, but to try to understand whether it is normal or something to be concerned about.

• Physiological bowing is common in young babies and usually resolves on its own by the age of 2.
• In Blount's Disease, the bowing of the leg is severe, does not improve on its own, and may become progressively worse.
• If you have any doubts, definitely see a pediatrician or orthopedic surgeon .
• Early diagnosis and treatment are the best way to ensure the child's future well-being.

There is no greater joy than seeing your child healthy and happy. Therefore, it is very important to be aware of such things.

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