RESUMEN
Background: This report on Blount’s disease after evaluation and sessions of exercises has shown the difficulties of obese patient in performing exercises with post surgical weakness. Case Summary: Blount Disease (Tibia Vara) Idiopathic tibia vara, or Blount disease, is the most common pathologic disorder producing a progressive genu varum deformity. It is characterized by abnormal growth of the medial aspect of the proximal tibial epiphysis, resulting in a progressive varus angulation below the knee. Tibia vara can occur at any age in a growing child. It is classified according to the age: infantile (1 to 3 years), juvenile (4 to 10 years), and adolescent (great than 11 years). The infantile group is the most common. The degree of deformity is measured by the distance between the two medial femoral condyles when the patient is lying. Multiple factors such as ethnicity, genetics, and mechanical stress are thought to be contributing elements to this disease. Diagnostic radiography is the method of choice in diagnosing Blount’s disease in children, and common radiographic manifestations include a rounded, dome – like tibial metaphysis with fracturing or change in size of the epiphysis. During the earliest stage of infantile Blount disease, bracing has been utilized in an attempt to correct the varus angle of the proximal tibia. Intervention: When performing osteotomies or with pin insertion, nerves as well as the anterior tibial artery and its recurrent branch, are at risk. With acute correction of the varus deformity, medial-side structures are at risk for stretch injury. Compartment syndrome is a risk particularly with acute correction of tibial deformity. Both through the surgical and/or conservative management, Physical therapy care should be continued to prevent muscle wasting, correct malalignment, strengthening the muscles, promote healing, weight reduction…etc Conclusion: Obesity being one of the prime barrier to overcome and complete the exercises, use of aquatic therapy is favourable. Weakness of muscles have to be checked right from the time condition was diagnosed. Proper bracing and strengthening exercises along with moral support and gaining confidence are key for better prognosis.