Hello Colleagues and Guests,
I recently saw a post about treatment plans for Blount’s Tibia Vara.
Back in the day, literally, we had occasion to make a nocturnal orthosis
that consisted of an equilateral welded triangle 12-14″, or so, 1/4″
nickle plated rod that would keep the knees flexed to 90 degrees. Of
course there were other elements of the device. I can’t remember all of
the details, but do remember that it was used only as night, kept the
knees flexed to approx. 90 degrees, knees were held close to the
triangle, and the feet were externally rotated, much like a Dennis
Browne would provide. I realize there could be negative consequences at
the knee joint with such an approach, but it seemed like a logical
orthotic treatment at the time and was commonly used. Does anyone have
pictures of this old system? I’ve scoured the search engines and cannot
find a reference. At a minimum, if anyone remembers negative
consequences or outcomes from these systems, I’d appreciate a comment.
Otherwise, I think it still makes sense as an adjunct to the typical 3
Point KAFO system that is used during ambulation. Since internal tibial
rotation is an element of Blount’s, 3-point pressures alone don’t seem
like an ideal approach. Thanks for your ole-timer’s comments.
A good friend once told me that you can’t make a silk purse out of a
sow’s ear. Another friend told me it was hard to troubleshoot gait
anomalies blindfolded (clueless) unless you have really really really
good hearing. The older I get, the more I understand such matters.
Wil Haines, CPO