Identical twins with Blount’s disease: 10-year follow-up

We present the case of monozygous twin girls, aged 3 years and 2 months, each presenting with unilateral left sided Blount's disease. Despite shared genetics and similar initial presentations, one twin had early loss of fixation of her tibial osteotomy and required multiple additional corrective procedures. This case highlights the need for personalised management plans and the requirement for agility in the application of treatment algorithms, given the potential risks of tibial osteotomies and k-wire fixation. At 10 years follow-up, both patients had satisfactory lower limb alignment and excellent patient reported outcomes.