Bowed Legs, or Genu Varum, is a structural deformity of the lower limbs in which the knees are pulled apart while the feet are joined together. It is commonly observed in toddlers and is evident due to the large spacing between the legs as well as knees. The condition may affect either one or both the legs and usually subsides on its own by the age of 3-4 years.
Causes
- Congenital defects– Folding of the legs in the mother’s womb may lead to bow leg formation in babies
- Rickets– A bone disease that occurs due to deficiency of Vitamin D or Calcium and phosphorus
- Blount’s Disease– Abnormality of the growth plate in tibia
- Fractures of the leg that have not healed properly
Symptoms
- Visibly deformed legs that may tend to curve outwards
- Abnormal gait
- Symptoms are more apparent when the child walks or stands
- Intoeing or inward turning of the feet while walking
- Tendency to trip while walking
- If the condition persists in adolescence, it may put stress on the hips, knee, ankle and pelvis
Diagnosis
- Detailed physical examination of the child, birth history and medical condition, if any
- The doctor may check if the bowing is symmetrical (occurs in both legs equally) or asymmetrical (one leg bends more than the other). This is done by measuring the distance between the knees while making the child lie on the stomach
- X-ray imaging may be required to assess the bone structure and underlying cause
- Blood tests may be done to check for conditions like Rickets
Treatment
- Regular clinical assessments every few months may be recommended to keep a check on the progress of the condition
- Bracing of the legs may be helpful if Blount’s Disease is diagnosed during early childhood
- Specific medication may be prescribed to control effects of Rickets
Surgical intervention may be needed in case the condition worsens and does not subside with conservative treatment. This may include:
- Tibial Osteotomy– Realigning or reshaping the shin bone and holding it in correct anatomical position using pins, plates, screws etc.
- Guided Growth– Surgical procedure to stop the growth of the healthy side of the shin bone to facilitate recovery on the damaged side of the leg
- Physical therapy may be helpful post-surgery to regain strength and stability of the leg
- The child may be advised to use walker or crutches for some time to avoid weight bearing
