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Paediatrics
intermediate
X-Type

Tibia Vara (Blount Disease) - Langenskiöld Staging and Management

Paediatric Lower Limb

A 3-year-old African-Caribbean boy is referred with progressive bilateral leg bowing. He began walking at 9 months and is above the 95th percentile for weight. Examination shows bilateral genu varum that worsens on standing, with internal tibial torsion. Standing AP radiographs demonstrate metaphyseal-diaphyseal angles (MDA) of 14 degrees bilaterally with medial metaphyseal beaking. The orthopaedic surgeon discusses the diagnosis and staging of Blount disease. Regarding Blount disease (tibia vara) and the Langenskiöld classification:

Mark each as TRUE or FALSE

A

The LANGENSKIÖLD CLASSIFICATION (Stages I-VI) describes progressive radiographic changes: Stage I sh...

B

The METAPHYSEAL-DIAPHYSEAL ANGLE (MDA/Drennan angle) is measured on standing AP radiograph: a line a...

C

Blount disease affects the LATERAL proximal tibial physis; Langenskiöld Stage I represents complete ...

D

DIFFERENTIATION from physiologic genu varum: physiologic resolves by age 2-3 years; MDA remains unde...

E

INFANTILE BLOUNT (age 1-3 years) is often BILATERAL (60-80%); risk factors include early walking, ob...

Answer the questions to see explanations

Click T (True) or F (False) for each option