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This systematic review sums up the state of knowledge about complications and reasons for failure when children with Blount disease are treated with temporary hemiepiphysiodesis. Twelve studies meet the inclusion criteria. The main reported obstacles were under correction and the poor predictability of the amount of correction that was obtainable. Obese patients with severe deformity are the most challenging groups of patients in the treatment of angular deformities. Patients with Blount disease require a careful evaluation regarding the deformity, age, body weight, and social background to reach the optimal treatment strategy. If hemiepiphysiodesis fails, osteotomy remains the preferred salvage procedure. Level of Evidence: IV.