Wang Bing, Miao Zukang, Yu Xiuchun, Zhou Ke, Liu Ning, Zhai Kai, Zheng Shu, Sun Haining
Department of Orthopedics, 960th Hospital of the People's Liberation Army, Jinan, China.
Front Endocrinol (Lausanne). 2025 Apr 9;16:1547679. doi: 10.3389/fendo.2025.1547679. eCollection 2025.
Currently, Blount's disease is treated in a variety of ways, but the optimal timing of treatment and the choice of optimal treatment regimen have yet to be determined. We report a case of a patient who failed multiple surgical treatments and underwent 3D-printed osteotomy guide-assisted proximal tibial orthopedic external fixation in adulthood to restore normal lower limb mechanical axis and suggest optimal treatment modalities in light of the systematic literature.
A case of Blount's disease patient who was misdiagnosed and missed and underwent multiple surgical treatments was retrospectively studied. According to the PRISMA statement, a systematic review of electronic databases such as PubMed, Embase, and Web of Science was conducted to explore the optimal timing of surgery for Blount's disease from 2010.
A boy born in 2001 was found to have a varus deformity in his left knee joint at the age of 2 years, which was not diagnosed. At the age of 7 years, he was diagnosed with Blount's disease and underwent multiple surgeries over the following years, all of which resulted in recurrences. At the age of 21 years, he underwent high osteotomy and external fixation of the proximal left tibia using a 3D-printed guide plate in our hospital. At present, the external fixation has been taken out, and the lower limb force line has recovered well. The timing and choice of treatment for Blount's disease are important for the patient's prognosis. The systematic review analyzed a total of 23 studies with a combined sample size of 679 cases, it provides recommendations for treatment strategies based on patient age.
The patient's age and degree of deformity are key in determining the timing and treatment plan. For patients with early-onset, who are under four years old, they may begin with a conservative treatment strategy, moving to a timely osteotomy if the initial approach proves ineffective. For patients with late-onset, 4-10 years old, there are no recommendations for definitive treatment at this time. Patients over 10 years old should have their bone age and growth potential evaluated, with epiphysiodesis recommended for those with a growth potential greater than 2 years and osteotomy recommended for those with less than 2 years to achieve a complete correction of the deformity.
目前，布朗特氏病有多种治疗方式，但最佳治疗时机和最佳治疗方案的选择尚未确定。我们报告了一例患者，其多次手术治疗均失败，成年后接受了3D打印截骨导向器辅助的胫骨近端矫形外固定，以恢复正常下肢力线，并根据系统文献提出最佳治疗方式。
回顾性研究一例布朗特氏病患者，该患者曾被误诊且延误治疗，接受过多次手术治疗。根据PRISMA声明，对PubMed、Embase和Web of Science等电子数据库进行系统综述，以探究2010年以来布朗特氏病的最佳手术时机。
一名2001年出生的男孩在2岁时被发现左膝关节内翻畸形，但未得到诊断。7岁时，他被诊断为布朗特氏病，在随后几年里接受了多次手术，均复发。21岁时，他在我院接受了使用3D打印导板的左胫骨近端高位截骨及外固定术。目前，外固定已拆除，下肢力线恢复良好。布朗特氏病的治疗时机和选择对患者预后很重要。该系统综述共分析了23项研究，合并样本量为679例，它根据患者年龄为治疗策略提供了建议。
患者年龄和畸形程度是确定治疗时机和治疗方案的关键。对于发病早、4岁以下的患者，可先采用保守治疗策略，若初始方法无效则及时进行截骨术。对于发病晚、4 - 10岁的患者，目前尚无明确治疗建议。10岁以上患者应评估骨龄和生长潜力，对于生长潜力大于2年的患者建议行骨骺阻滞术，对于生长潜力小于2年的患者建议行截骨术以实现畸形的完全矫正。
