Effectiveness of brace treatment in early infantile Blount's disease

In an effort to determine whether bracing is effective in reversing early i nfantile Blount's disease, 27 patients with Langenskiold stage II disease w ere studied. Ten patients had bilateral disease (two of these patients had stage III disease affecting one side). Age at brace initiation averaged 2.1 years (range, 1.5-3.2). The duration of bracing averaged 9.7 months. Follo w-up averaged 5.9 years. Successful outcomes (improved alignment without th e need for osteotomy) were achieved in 19 (70%) patients, the majority of t hem having unilateral disease. Of the 37 affected extremities, 24 (65%) had successful outcomes. Eight patients (13 extremities) required tibial osteo tomies and were classified as bracing failures. Of the 10 patients with bil ateral involvement, seven (70%) required osteotomies for one or both extrem ities. whereas only one (6%) of 17 patients with unilateral involvement req uired osteotomy. Bracing appears to be effective in stage II infantile Blou nt's disease, particularly in those with unilateral involvement. Children w ith bilateral disease are most at risk for requiring subsequent correction osteotomy.