Tibia vara. A critical review.

Since Blount's classic article was published in 1937, many authors have contributed to the knowledge of tibia vara. Tibia vara is characterized by an abrupt angulation of the tibia into varus in the proximal end. The term does not reveal the etiology of the anatomic deformity, which may be developmental, posttraumatic, or postinfectious. There are four types: (1) Infantile tibia vara (Blount's disease) is a developmental condition that manifests itself between the ages of one and four years. Roentgenographic findings are typical. (2) Adolescent tibia vara is caused by partial closure of the growth plate after trauma or infection between the ages of six and 13 years. (3) Late-onset tibia vara appears in obese black children between the ages of six and 15 years. The roentgenographic findings differ from those of the other types, but the histopathology is similar to infantile tibia vara. (4) Tibia vara may also be caused by focal fibrocartilaginous dysplasia. Eight cases in which there was an area of fibrocartilaginous dysplasia in the medial aspect of the tibia have been reported in the literature. Several problems have been encountered in the treatment of infantile tibia vara.