Prevalence and Risk Factors of Blount's Disease Among Children and Adolescents in Saudi Arabia: A Cross-Sectional Study

Abstract

Background Blount disease is a disorder characterized by developmental deformity of lower limbs that produces varus deformity of the tibia which result from progressive abnormal osteogenesis from proximal tibialphysis and characterized as a tibial vara as it develops and it involves many adjustable elements like weight loss, deficiency in Vitamin D and mechanically high pressure factors the Saudi prevalence characteristics are minimal in research.
Objectives: This study objective is to estimate clinical incidence rate and potential associated risk elements that the degree of BMI, Vit D and gender and area characteristic features among pediatrics patients whom referred to orthopedic clinics within Aseer Region in Saudi Arabia.
Method: The study was an 18 months duration, with observational transversal setting, enrolled 600 pediatrics cases with clinical observation from age 2-19 years (9.85 4.12 yr). From 600 cases (312 were male= 52% and 288were female= 48%), BMI for every patients calculated by WHO parameters (<85 = normal weight, 85–95 =over weight, >95% is obese). Serum Vit D level(<20ng/mL Deficient, 20–30ng/mL insufficient, >30ng/mL Sufficient). Radiographic Severity Langenskild staging as severity staging. Invariable testing was conducted ( Chi-Square test/Fisher’s exact test) . The potential independence prediction power on occurrence have be studied through Multivariable logistic regression analysis .
Results: Among total 600 of patients who seen in orthopedic clinics, 215 were Blount’s patients ( incidence rate = 35.8%). Obesity related factors were significant indicator for Blount's disease patients (Chi-Square value= 112.45; p<0.001). The incidence among male patients were higher than those among females (Chi-Square value= 14.82; p<0.001). Family History was independently associated with prevalence of the condition (Chi-Square value= 20.25; p<0.001). According to multiclass binary regression , high percentile of BMI ( Odds ratio =3.61; 95% coif interval (2.84–4.59); p<0.001), and deficiency of vitamin D( odds ratio=2.80; 95% confidence interval(1.64–4.76) p<0.001 ) and Male gender(odds ratio= 1.85; 95%CI; (1.32–2.58) p=0.001) had a highest predictability of development of Blount disease, but on other hand vitamin D deficiency alone was also predictive for disease existence ( odds ratio =2.31; 95% CI (1.32-4.05), p = 0.003).
Conclusion: Obesity, lack of Vitamin D, and Male sex were significant risk independent prediction variables of clinical Blount's disease occurrence for children in Aseer Region, Saudi Arabia. Public health actions by aggressive weight management and vitamin D repletion along targeted screening may reduce future complications.