Bow legs and knock knees

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Bow legs and knock knees are two common lower limb alignment conditions seen in children and sometimes adults. They affect the position of the knees and legs, and in some cases, may lead to discomfort, uneven walking, or joint problems if left untreated.

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🦵 1. WHAT ARE BOW LEGS (Genu Varum)?

• Legs curve outward at the knees when standing with feet together.

• Creates a wide space between the knees.

• Common in infants and toddlers, often improves naturally with growth.

🔍 Causes

Type	Examples
Physiological	Normal in babies up to age 2
Pathological	Rickets (vitamin D deficiency), Blount’s disease, bone dysplasia
Trauma/Injury	Growth plate damage or fractures

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🦿 2. WHAT ARE KNOCK KNEES (Genu Valgum)?

• Knees angle inward, touching or overlapping when standing with ankles apart.

• Common in children aged 3–7, usually resolves with age.

🔍 Causes

Type	Examples
Physiological	Normal in preschool age
Pathological	Rickets, obesity, skeletal dysplasias, trauma
Genetic	Family history of leg alignment issues

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🧪 WHEN IS TREATMENT NEEDED?

• Asymmetrical legs (one bowed/one normal)

• Condition worsens after age 3–4 (for bow legs) or age 7–8 (for knock knees)

• Pain, limping, or joint stress

• Heightened risk of arthritis, meniscus damage, or patellar tracking disorder

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💊 TREATMENTS FOR BOW LEGS & KNOCK KNEES

🔹 1. Observation

• Most cases in young children are self-correcting

• Regular monitoring with X-rays or growth charts

🔹 2. Non-Surgical Approaches

Option	Benefit
Bracing	Guides growth in children with mild/moderate deformity
Physical therapy	Strengthens leg muscles, improves gait
Orthotics (shoe inserts)	Offers support but limited correction
Vitamin D and calcium	If due to rickets or nutritional bone issues
Weight management	Especially for knock knees in overweight children

🔹 3. Surgical Treatment (if severe or persistent after growth age)

Surgery	Purpose
Guided growth (hemiepiphysiodesis)	Small metal plate restricts one side of growth plate
Osteotomy	Bone is cut and realigned
External fixators	For complex deformities or limb lengthening

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🩺 LONG-TERM OUTLOOK

• Excellent in most children with mild cases.

• In rare, severe cases, untreated deformities can cause:

  • Arthritis

  • Leg length discrepancies

  • Hip/knee pain

  • Altered walking mechanics