Can Blount's disease heal spontaneously?

Introduction: In stage 1 of all currently accepted classifications for infantile tibia vara, the diagnosis is difficult between physiological bowing and true Blount's disease. There is no evidence of prognosis criteria for surgical treatment at this stage. Patient and methods: We retrospectively studied a series of 26 patients born in the Indian Ocean area, presenting at stage 1 of the disease, in order to determine whether any of them were likely to heal without treatment. Results: It was found that children seen at stage 1 of infantile tibia vara have a one-in-three chance of healing spontaneously. Discussion: An alternative classification in three stages could then provide more suitable therapeutic indications: stage 0: possible Blount's disease (patient older than 2.5 years); stage 1: certain Blount's disease, active physis (+) (progressive varus, age > 3 years, typical image with no epiphysiodesis bridging); stage 2: certain Blount's disease, inactive physis (-) (superomedial tibial bony bridge). Level of evidence: Level IV. Retrospective study. (C) 2010 Elsevier Masson SAS. All rights reserved.