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El jugador de fútbol, que era muy activo en el deporte, informó de un dolor creciente en la rodilla sin recordar ningún incidente en particular.\n\nEn la primera presentación en el ZEM-Germany el genu varo de la pierna derecha era ya tan pronunciado que en un principio se tuvo que desaconsejar una actividad deportiva posterior. A nivel de la articulación de la rodilla derecha, el eje de carga estaba desplazado 105 mm en sentido medial, por lo que existía un riesgo agudo de lesión del menisco medial. También había una desviación moderada del eje de carga de 24 mm en el lado izquierdo. Debido a la fuerte incurvación de la pierna derecha, también se produjo un acortamiento de la pierna de más de 2 cm en este lado.\n\n**Diagnóstico: sospecha de forma juvenil de la enfermedad de Blount**.",[],[337],"lg:col-span-6",{"_uid":339,"image":340,"title":343,"component":344,"copyright":9,"image_style":345,"component_style":346},"681b5e04-476c-4569-bb0a-6e5d6fa49476",{"id":341,"alt":102,"name":9,"focus":102,"title":102,"filename":342,"copyright":102,"fieldtype":11},4678155,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F1628x3256\u002Fc8db537102\u002Fcase_17_1.png","Presentación inicial","Image",[],[347],"col-span-3",{"_uid":349,"image":350,"title":353,"component":344,"copyright":9,"image_style":354,"component_style":355},"3bb80328-fb66-4beb-a733-4e2ba385100e",{"id":351,"alt":102,"name":9,"focus":102,"title":102,"filename":352,"copyright":102,"fieldtype":11},4678156,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F4015x8031\u002Fbea36e1e20\u002Fcase_17_2.png","LSR antes del tratamiento",[],[347],{"_uid":357,"text":358,"component":324,"text_style":359,"component_style":360},"eb1da6c7-dc84-492b-abdb-78b765d5dfe3","## Tratamiento",[],[],{"_uid":362,"text":363,"component":324,"text_style":364,"component_style":365},"cb816814-a9dc-4843-ad55-482184380a72","Con el fin de utilizar el crecimiento residual para el enderezamiento, se realizó un grapado fisario temporal en la parte externa de la parte superior e inferior de la pierna derecha en una primera y pequeña operación. Sin embargo, sólo hay una pequeña oportunidad para este tipo de procedimientos de modulación del crecimiento, que pueden evitar operaciones posteriores mucho más extensas. En este caso, sólo se pudo lograr una corrección parcial debido a la tardía presentación inicial en el ZEM-Germany.\n\nPor lo tanto, después de completar el crecimiento de la longitud, las deformidades restantes tuvieron que ser corregidas quirúrgicamente como estaba previsto, primero en el muslo y 3 meses después también en la parte inferior de la pierna. En todo momento el niño tuvo movilidad con muletas en el antebrazo y pudo cargar 20 kg de peso en la pierna derecha hasta que el hueso sanó por completo.",[],[],{"_uid":367,"image":368,"title":371,"component":344,"copyright":9,"image_style":372,"component_style":373},"fd67caef-6c85-477c-9540-f71c37a07f94",{"id":369,"alt":102,"name":9,"focus":102,"title":102,"filename":370,"copyright":102,"fieldtype":11},4678157,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F3902x7804\u002F3ce7f3e873\u002Fcase_17_3.png","1ª OP: placas en 8 (8-plates)",[],[374],"lg:col-span-4",{"_uid":376,"image":377,"title":380,"component":344,"copyright":9,"image_style":381,"component_style":382},"16ebe76f-346a-4bd0-9b45-d39f6d439b08",{"id":378,"alt":102,"name":9,"focus":102,"title":102,"filename":379,"copyright":102,"fieldtype":11},4678158,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F3937x7875\u002F92de0e4625\u002Fcase_17_4.png","2ª OP: corrección supracondílea del eje",[],[374],{"_uid":384,"image":385,"title":388,"component":344,"copyright":9,"image_style":389,"component_style":390},"bba625e5-a4e9-4b70-aeb6-5d93471aa7d0",{"id":386,"alt":102,"name":9,"focus":102,"title":102,"filename":387,"copyright":102,"fieldtype":11},4678161,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F3943x7885\u002Fe0e9c0d7f4\u002Fcase_17_6.png","3ª OP: HTO",[],[374],{"_uid":392,"text":393,"component":324,"text_style":394,"component_style":395},"1181f33c-c9bd-4e52-aa88-552fdf66612e","## Resultado",[],[],{"_uid":397,"text":398,"component":324,"text_style":399,"component_style":400},"68158ab6-4bd0-4663-ab7d-a0af18c62a95","La medición de las piernas tras la consolidación y la retirada de los implantes muestra un eje de la pierna centrado y recto en el lado derecho. El hueso ha cicatrizado completamente y vuelve a ser estable bajo carga. También se ha compensado el acortamiento de la pierna. La corrección evitó así posibles daños consecuentes en la articulación de la rodilla debido a una sobrecarga unilateral y también una mala posición de la columna vertebral. Entretanto, el joven puede volver a hacer deporte sin restricciones y confía en que algún día se convertirá en un famoso jugador de fútbol profesional.\n\nEspecialmente en vista de la intensa actividad deportiva, también debe corregirse el genu varo (piernas en O) de la pierna izquierda. No es una decisión fácil para el joven entusiasta del deporte, pero es una \"obligación\" debido a sus ambiciones deportivas.",[],[337],{"_uid":402,"image":403,"title":406,"component":344,"copyright":9,"image_style":407,"component_style":408},"46bd2779-7e4e-4ca9-85d0-ca4e8c5e5e49",{"id":404,"alt":9,"name":9,"focus":9,"title":9,"filename":405,"copyright":9,"fieldtype":11,"is_external_url":12},6398541,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F1916x3832\u002F88b3646043\u002Fcase_17_7.png","Finalización del tratamiento",[],[347],{"_uid":410,"image":411,"title":414,"component":344,"copyright":9,"image_style":415,"component_style":416},"1d05f553-37ea-448c-bd13-9bfa5b78efb5",{"id":412,"alt":9,"name":9,"focus":9,"title":9,"filename":413,"copyright":9,"fieldtype":11,"is_external_url":12},6398542,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F4039x8078\u002F9712812826\u002Fcase_17_8.png","Una pierna derecha recta tras las correcciones quirúrgicas de la parte superior e inferior de la pierna",[],[347],{"_uid":418,"title":419,"stories":420,"component":435},"b0322016-634a-4d3f-b56a-f323cbdf48e7","Más información",[421,428],{"uuid":422,"full_slug":423,"content":424},"86228d29-bbca-475a-aa21-70488bd57989","es\u002Fespectro-de-tratamiento\u002Fmodulacion-del-crecimiento",{"_uid":425,"_editable":-1,"image":426,"intro":427,"meta_title":236},"014d88f1-63fb-4452-b085-53b3871ff985",{"id":102,"alt":102,"name":9,"focus":102,"title":102,"filename":9,"copyright":102,"fieldtype":11},"Mientras los cartílagos de crecimiento de los niños y adolescentes sigan abiertos, el crecimiento alterado puede corregirse con una intervención quirúrgica muy pequeña en muchos casos. Esto significa que en algunos pacientes se puede evitar una operación importante en la edad adulta, una oportunidad para la que sólo hay un pequeño margen de maniobra.",{"uuid":429,"full_slug":430,"content":431},"32ab2fac-1046-4990-a929-feda0ef7185d","es\u002Fespectro-de-tratamiento\u002Fcorreccion-de-ejes-y-torsiones",{"_uid":432,"_editable":-1,"image":433,"intro":434,"meta_title":233},"7b24a0c9-239e-42e8-9a57-d06554cf5cc4",{"id":102,"alt":102,"name":9,"focus":102,"title":102,"filename":9,"copyright":102,"fieldtype":11},"Las alteraciones de la geometría normal de la pierna pueden provocar una carga anormal en las articulaciones y un desgaste articular prematuro. Tanto en los jóvenes, como medida preventiva, como en las personas mayores, cuando ya se ha producido el desgaste, las correcciones del eje o de la torsión son una importante opción de tratamiento para la conservación de la articulación y, en muchos casos, pueden evitar o al menos retrasar la necesidad de una sustitución de la articulación de la rodilla artificial.","Reference",{"id":341,"alt":102,"name":9,"focus":102,"title":102,"filename":342,"copyright":102,"fieldtype":11},"El paciente se presentó por primera vez a los 13 años de edad con un genu varo (piernas en O) del lado derecho que había ido aumentando durante dos años.","Page",[],[441],"max-w-screen-lg","morbus-blount","es\u002Festudios-de-caso\u002Fenfermedad-de-blount",170,[],5185868,"63c1024d-ce8f-417c-abba-bab7303f4f95","2020-12-29T13:15:35.000Z",[],"fallbeispiele\u002Fmorbus-blount",[452,456,458,462,466],{"path":453,"name":454,"lang":455,"published":21},"cases\u002Fblounts-disease","Blount's disease","en",{"path":457,"name":301,"lang":204,"published":21},"estudios-de-caso\u002Fenfermedad-de-blount",{"path":459,"name":460,"lang":461,"published":21},"drasat-alhalh\u002Fmrdh-blwnt","مرض بلونت","ar",{"path":463,"name":464,"lang":465,"published":21},"tematicheskie-issledovaniya\u002Fbolezn-blaunta","Болезнь Блаунта","ru",{"path":467,"name":468,"lang":469,"published":21},"an4-li4-yan2-jiu1\u002Fbu4-lang3-te4-shi4-bing4","布朗特氏病","zh",1793077541713]