Langenskiold classification of Blount disease

Last revised by Yuranga Weerakkody on 22 Jan 2019

The Langenskiold Classification of Blount disease uses age and severity of deformity as grading parameters.


Six stage radiographic classification of infantile tibia vara, which is based on changes observed as the child matured:

  • stage I: 2-3 years
    • irregularity of metaphyseal ossification zone  
    • delayed development of a medial portion of the epiphysis
    • medial metaphysis beaked medially and/or distally
  • stage II: 2.5-4 years
    • sharp depression of physeal line medially
    • medial beaking 
    • medial part of epiphysis more wedge-shaped and underdeveloped
  • stage III: 4-6 years
    • deepening depression of metaphyseal beak
    • appearance of "step" in metaphysis
    • increasing wedging and underdeveloping of the epiphysis 
  • stage IV: 5-10 years
    • physis narrows
    • epiphysis enlarges
    • increasing depth of “step” in metaphysis
    • epiphysis occupies depression in the medial metaphysis
  • stage V: 9-11 years
    • bony epiphysis separated into two portions by a clear band  
    • partially double epiphyseal plate
    • slope to the medial articular surface
  • stage VI: 0-13 years
    • branches of the medial part of physis ossify - medial growth arrest
    • normal growth of the lateral part

See also

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