Bowlegs and Knock-knees in Children (Genu Varum and Genu Valgum)

knock knees and bow legs are two separate conditions that both involve incorrect positioning of the legs.
knock knees or genu valgum refers to a condition whereby the legs curve inwards in standing position .
the ankles and feet will remain wide apart when the child stands with their knees placed together .
bow legs or genu verum refers to a condition where the legs curve outwards in standing position.
as opposed to knock knees the knees will remain wide apart when the child stands with ankles and feet together.
a common concern for parents, bow legs and knock knees are primarily due to the child's normal growth and development and only a very small number of children need treatment.
however sometimes these conditions can be caused by illnesses that need to be treated .
understanding how a child's legs change as they grow is important in understanding these conditions.
bow legs in children under 2 is a normal part of development.
you may notice the bowing getting worse by 18 months.
however the bowing will slowly improve.
when the child is around two years the legs have usually straightened.
starting around two years of age the leg alignment may start going to knock kneed.
knock knees peaks at three years of age around six or seven years of age you will notice normal leg alignment.
how is it treated?
unless there is an underlying cause or the child's condition is extreme no treatment is generally necessary.
for the vast majority of children treatment only involves observation allowing growth and time to correct the legs .
when you should worry about your child knees?
when should an orthopedic surgeon be consulted?
if your child has any of the following he may have a serious condition that requires a doctor's consultation.
bow legs that fail to resolve or progress after the age of three.
knock knees that become apparent before age two or after age seven.
your child has a limp or pain associated with
the condition.
your child is unusually short for their age.
the symptoms present on only one side.
some conditions that may need treatment.
in addition to severe physiologic curvature there are conditions need treatment such as: ricketts disease
ricketts disease is a disorder caused by a lack of vitamin d calcium or phosphate.
it leads to softening and weakening of the bones and may cause bow legs or knock knees .
ricketts disease is usually diagnosed by the patient's pediatrician through lab tests or x-rays .
while conservative treatments are most often recommended surgery may be required based on disorder severity .
blount's disease:
it is a disorder caused by an abnormal growth plate in the upper tibia which causes bowleg.
treatment of blount's disease depends on the severity of the deformity in the age of the child and may involve observation or surgery.
a late vulgas deformity following proximal tibia metaphysial fractures known as a cousin's phenomenon
it develops 5-15 months after injury .
maximum deformity observed at 12 to 18 months after fracture.
the treatment is observation for 12 to 24 months with expectation of spontaneous correction in most cases.
although some patients may have a persistent bulgous deformity.
the surgery is reserved for vulgar deformities greater than 20 degrees near skeletal maturity.
physeal injury from trauma, infection or vascular insult .
it is treated surgically.
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