Early walking, large stature, obesity
Bracing and surgery
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Figure 29 shows the AP radiograph of a 14-year-old boy. The radiographic findings are most consistent with what pathologic process?
Juvenile rheumatoid arthritis (JRA)
Adolescent Blount’s disease
Infantile Blount’s disease
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Examination of an obese 3-year-old girl reveals 30 degrees of unilateral genu varum. A radiograph of the involved leg with the patella forward is shown in Figure 10. Management should consist of
continued observation until skeletal maturity.
fitting for a valgus-producing hinged knee-ankle-foot orthosis.
lateral proximal tibial hemiepiphysiodesis.
proximal tibiofibular osteotomy and acute correction.
proximal tibiofibular epiphysiodesis and osteotomy with lengthening.
A 30-month-old boy has worsening bilateral bowleg deformities, and radiographs depicting Langenskiold stage II are shown in Figure A. The most appropriate initial management should consist of which of the following?
Bracing with knee-ankle-foot orthoses
Bracing with ankle-foot orthoses
Proximal tibia/fibula valgus osteotomy with bar resection
Proximal tibia/fibula valgus osteotomy with hemiepiphysiodesis
A valgus producing proximal tibial osteotomy with 10 degrees of overcorrection is the most appropriate treatment for which of the following patients with tibia vara?
A 4-year-old obese child with Blount's disease, Langenskiöld stage IV
An 18-month-old child with a proximal tibia metaphyseal-diaphyseal angle of 11 degrees
A 2-year-old obese child with Blount's disease, Langenskiöld stage II disease
A 5-year-old child with untreated renal osteodystrophy and a proximal tibia metaphyseal-diaphyseal angle of 16 degrees
A 8-year-old child with distal femoral varus and a lateral distal femoral angle of 95 degrees
A 32-month-old male with severe infantile Blounts disease has been treated with full time bracing for the past year. At most recent follow-up, the varus deformity of his bilateral legs has worsened despite compliance with bracing. What treatment is now recommended?
Observation, discontinuation of bracing
Observation, continuation of full-time bracing
Bilateral proximal tibial osteotomies
Bilateral distal femur osteotomies
Bilateral proximal tibial medial hemiepiphysiodesis
Lateral tibial physeal stapling is a treatment option for adolescent Blount’s disease. How is the staple an example of the Hueter-Volkmann principle?
Increased compression along the growth plate slows longitudinal growth
Decreased compression along the growth plate slows longitudinal growth
Increased tension along the growth plate slows longitudinal growth
Decreased tension along the growth plate slows longitudinal growth
Increased compression along the plate increases longitudinal growth