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BLOUNTS DISEASE

Disusun Oleh :

DODDY TISNA

Pembimbing :Dr. Giri Marsela, Sp.OT

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PENDAHULUAN

Tibia vara dapat terjadi pada setiap kelompok umur

pada anak yang sedang diklasifikasikan sebagai

infantil (1-3 tahun), juvenil (4-10 tahun), dan remaja

(11 tahun atau lebih tua). Prevalensi Bentuk kekanak-kanakan lebih sering

terjadi pada anak perempuan. Bentuk remaja atau

remaja lebih sering terjadi pada anak laki-laki.

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PENDAHULUAN

Kelainan ini lebih sering terjadi pada anak-anak

Amerika Afrika dibandingkan dengan ras lain.

Faktor Risiko untuk penyakit blount, antara lain :

Afrika Amerika etnis, Kegemukan dan Usia diniberjalan. Varus lebih besar pada tibial dari sisi

femoralis adalah faktor risiko untuk penyakit Blount

kekanak-kanakan dan remaja.

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DEFENISI

Tibia vara idiopatik atau penyakit Blount

adalah gangguan yang jarang terjadi yang

ditandai oleh kelainan pertumbuhan sisi media

epifisis tibia proksimal, mengakibatkan

angulasi varus progresif di bawah lutut.

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ETIOLOGI

Penyakit blount terjadi pada anak-anak dan remaja.

Penyebab penyakit ini belum diketahui, tetapi

diperkirakan karena efek dari kelainan pada lempeng

pertumbuhan. Pada komponen bagian dalam tibia tepatnya di bawah

lutut terjadi kegagalan untuk berkembang secara

normal oleh karena adanya angulasi dari tulang.

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ETIOLOGI

Seperti pada bowleg, yang mana cenderung

ditujukan pada perkembangan anak-anak.

Penyakit blount bersifat progresif dan kondisi ini

buruk. Hal ini dapat dikarenakan pembengkokan yang

berat dari kaki dan dapat terjadi pada satu atau

kedua kaki.

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ETIOLOGI

Kondisi seperti ini lebih sering didapati pada

anak-anak keturunan afrika.

Penyakit blount juga dihubungkan dengan suatu

kegemukan, orang-orang pendek dan berjalanbelum saatnya. Penyakit ini tidak bisa

dihubungkan secara jelas dari faktor genetik.

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KLASIFIKASI DAN STAGING

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MANIFESTASI KLINIK

tonjolan metafisis media hebat,

torsi tibia interna,

ketidaksesuaian panjang kaki,

deformitas genu varum progresif lambat, dan

nyeri

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DIAGNOSA

Anamnesa yang lengkap

Pemeriksaan fisik

Pemeriksaan Laboratorium

Pemeriksaan radiologi

Foto Rontgen tibia

CT-Scan

MRI

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DIAGNOSA BANDING

Membungkuk fisiologis kaki

Hypophosphatemic rakhitis

Trauma plat metaphysis atau pertumbuhan

Osteochondroma

Metaphyseal chondrodysplasia

Focal fibrocartilaginous dysplasia

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KOMPLIKASI

Kambuhnya deformitas mengarah ke

ekstremitas keselarasan abnormal dan arthritis

degeneratif.

Limb-panjang bisa mengakibatkan ketimpangan.komplikasi Postosteotomy termasuk komplikasi

neurovaskular dan sindrom kompartemen.

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PROGNOSA

Karena tingkat kekambuhan lebih tinggi pada

pasien dirawat setelah 4 tahun (70-75%)

dibandingkan pada pasien yang diobati sebelum

usia 4 (20-30%), osteotomy dini (sebelum usia4) boleh dilakukan jika bracing tidak berhasil.

Pasien dengan pengobatan terlambat atau

pengobatan tidak lengkap memiliki peningkatan

risiko radang sendi lutut.

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PENATALAKSANAAN

Anjuran diet harian

Anjuran aktifitas fisik harian

Farmakoterapi

Melakukan tindakan umum

Operasi

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DAFTAR RUJUKAN

http://www.patient.co.uk/doctor/Blount%27s-

Disease.htm

http://en.wikipedia.org/wiki/Blount%27s_disease

http://indonesian.orthopaedicclinic.com.sg/?p=900

http://medicalcom.wordpress.com/2011/04/21/tibia-

vara/

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http://www.patient.co.uk/doctor/Blount%27s-Disease.htmhttp://www.patient.co.uk/doctor/Blount%27s-Disease.htmhttp://en.wikipedia.org/wiki/Blount%27s_diseasehttp://indonesian.orthopaedicclinic.com.sg/?p=900http://medicalcom.wordpress.com/2011/04/21/tibia-vara/http://medicalcom.wordpress.com/2011/04/21/tibia-vara/http://medicalcom.wordpress.com/2011/04/21/tibia-vara/http://medicalcom.wordpress.com/2011/04/21/tibia-vara/http://medicalcom.wordpress.com/2011/04/21/tibia-vara/http://indonesian.orthopaedicclinic.com.sg/?p=900http://en.wikipedia.org/wiki/Blount%27s_diseasehttp://www.patient.co.uk/doctor/Blount%27s-Disease.htmhttp://www.patient.co.uk/doctor/Blount%27s-Disease.htmhttp://www.patient.co.uk/doctor/Blount%27s-Disease.htm

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DAFTAR RUJUKAN

^ Clarke SE, McCarthy JJ, Davidson RS (March 2009). "Treatment of Blount

disease: a comparison between the multiaxial correction system and other external

fixators".J Pediatr Orthop29 (2): 1039. doi:10.1097/BPO.0b013e3181982a62.

PMID19352232. http://meta.wkhealth.com/pt/pt-core/template-

journal/lwwgateway/media/landingpage.htm?issn=0271-

6798&volume=29&issue=2&spage=103. ^synd/1470 at Who Named It?

^ W. P. Blount. Tibia vara: osteochondrosis deformans tibiae. Journal of Bone and

Joint Surgery, Boston, 1937, 19: 1-29.

^ McCarthy JJ, MacIntyre NR, Hooks B, Davidson RS (March 2009). "Double

osteotomy for the treatment of severe Blount disease".J Pediatr Orthop29 (2):

1159. doi:10.1097/BPO.0b013e3181982512. PMID19352234.

http://meta.wkhealth.com/pt/pt-core/template-

journal/lwwgateway/media/landingpage.htm?issn=0271-

6798&volume=29&issue=2&spage=115.

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http://en.wikipedia.org/wiki/Blount's_diseasehttp://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://en.wikipedia.org/wiki/Digital_object_identifierhttp://dx.doi.org/10.1097/BPO.0b013e3181982a62http://en.wikipedia.org/wiki/PubMed_Identifierhttp://www.ncbi.nlm.nih.gov/pubmed/19352232http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://en.wikipedia.org/wiki/Blount's_diseasehttp://www.whonamedit.com/synd.cfm/1470.htmlhttp://en.wikipedia.org/wiki/Who_Named_It?http://en.wikipedia.org/wiki/Blount's_diseasehttp://en.wikipedia.org/wiki/Blount's_diseasehttp://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://en.wikipedia.org/wiki/Digital_object_identifierhttp://dx.doi.org/10.1097/BPO.0b013e3181982512http://en.wikipedia.org/wiki/PubMed_Identifierhttp://www.ncbi.nlm.nih.gov/pubmed/19352234http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://www.ncbi.nlm.nih.gov/pubmed/19352234http://en.wikipedia.org/wiki/PubMed_Identifierhttp://dx.doi.org/10.1097/BPO.0b013e3181982512http://en.wikipedia.org/wiki/Digital_object_identifierhttp://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=115http://en.wikipedia.org/wiki/Blount's_diseasehttp://en.wikipedia.org/wiki/Blount's_diseasehttp://en.wikipedia.org/wiki/Who_Named_It?http://www.whonamedit.com/synd.cfm/1470.htmlhttp://en.wikipedia.org/wiki/Blount's_diseasehttp://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://www.ncbi.nlm.nih.gov/pubmed/19352232http://en.wikipedia.org/wiki/PubMed_Identifierhttp://dx.doi.org/10.1097/BPO.0b013e3181982a62http://en.wikipedia.org/wiki/Digital_object_identifierhttp://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0271-6798&volume=29&issue=2&spage=103http://en.wikipedia.org/wiki/Blount's_disease

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TERIMA KASIH

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