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Abstract
Bowleg deformities are commonly observed in toddlers and most of
them are physiologic bowing that recover spontaneously, but some
demonstrate severe tibia vara deformities with internal torsion and progress
to blount’s disease (Mukai et ai.,2000).
Tibia vara or Blount’s disease, is a relatively rare disorder primarily
involving the medial proximal tibial metaphysis, physis, and epiphysis. The
disorder was originally described by Erlacher in 1922. Blount, in 1937,
reported 15 cases from the literature coupled with 13 cases in his personal
series (Turker and Drennan, 1997). His excellent description of the tibia
vara has resulted in its being commonly called ”Blount’s disease”.
(Griffin, 1986). Initially, Blount distinguished two clinical forms
differentiated by age at presentation: 1- Infantile type, affects children
between the age of I and 3 years, and 2- the less common adolescent type
affects children older than 8 years of age (Warner et al., 1994).
Thompson et al., (1984), later proposed a three-group classification,
by adding a juvenile category because of the significant rate of recurrent
deformity in their patients between 3 and 10 years of age and the absence
of recurrence in patients who presented after 10 years of age. The three
groups classification proposed are: 1- Infantile: one to three years.
2- Juvenile: four to ten years. 3- Adolescent: eleven years or older.
Langenskiold, (1994), reported that since Blount, first described the
condition in 1937, four types of tibia vara have been defined: 1- The
infantile type (Blount’s disease), 2- The adolescent type caused by an
epiphyseal-metaphyseal bone bridge after trauma or osteomyelitis, 3- The
adolescent late onset type. 4- Tibia vara caused by focal fibrocartilaginous