About Genu Varum (Bow Legs)
Genu varum, also known as bow legs, is a condition where a person's legs appear to bow or bend outward. When standing straight with ankles together, there is a noticeable gap between the knees.
Bow legs can occur in infants due to the cramped positioning in the womb, but it typically corrects itself by the age of 3 without treatment. In older children and adolescents, persistent bow legs may be caused by underlying health conditions such as rickets or Blount's disease. Excess weight or obesity can also contribute to bow legs in adolescents.
Bow legs can affect the appearance and walking ability of individuals and may lead to knee pain in severe cases. Surgical interventions like high tibial osteotomy (HTO) can be used to treat severe cases.
Genu varum, also known as bow legs, is a condition that occurs in infants and toddlers due to their positions in the womb. It usually corrects itself as the child starts walking and typically resolves by around the age of 2 or 3.
However, if the condition remains after 3 years old, some of the common causes include:
- Blount's disease: This condition is characterized by an abnormality in the growth plate of the upper shinbone, a soft area of cartilage located at the ends of the shins in children and adolescents. It can cause bowing of the legs and becomes more noticeable after the age of 3.
- Rickets: Rickets is a disease that weakens bones and can lead to deformities such as bow legs. It is often caused by a deficiency in vitamin D, calcium, or phosphorus.
Risk factors for bow legs include:
- Genetic predisposition: Having a family history of bow legs or related conditions can increase the risk.
- Certain medical conditions: Conditions like skeletal dysplasia (dwarfism) or tibial hemimelia (shortening of the shin bone) can contribute to the development of bow legs.
It is generally recommended to maintain a healthy weight, engage in regular physical activity, and consume a balanced diet to support overall bone health. Remember to consult with a healthcare professional for personalized advice regarding possible risk factors.
The most common early symptoms of bow legs include:
- Visual separation of the ankles when the knees are together
- Limp and problems with balance while walking
- Occasional pain in the knees, feet, hip, or ankle
As bow legs progresses or becomes more severe, additional symptoms may occur, such as:
- Joint pain, especially when walking
- Stiff joints
- Knee pain
- Unbalanced stance if only one knee is affected
It's important to note that the severity and progression of symptoms can vary from person to person. If you are experiencing any of these symptoms or have concerns about bow legs, it is recommended to consult with a healthcare professional for an accurate diagnosis and appropriate management.
To diagnose bow legs, the following examinations, tests, and procedures are commonly performed:
- Physical examination: The health care provider will assess how much the legs are curved through a physical examination.
- Imaging: X-rays are taken from the front and side, as well as an angled view of the kneecap, with the knees bent at 45 degrees. This helps determine if a person has bow legs or knock knees.
To determine the stage or severity of bow legs, additional examinations, tests, and procedures may be done:
- Measurements: Distances between the knees, mid-tibiae (the middle of the lower leg bones), and inner ankles are measured to track progress over time without needing frequent X-rays.
- Thigh-foot angle: This angle is measured to evaluate how severe the twisting of the internal tibial torsion (lower leg bones).
- Assessing weight bearing joints: Alignment of weight-bearing joint, which are usually hips, knees, and ankles, is checked while standing to see if surgery might be necessary.
- Gait evaluation: Gait (walking pattern) is analyzed to see if there is any side-to-side knee movement while standing or walking that could cause knee instability, that could cause outward movements of the knee.
It's important to consult with your health care professional for personalized advice and to discuss which examinations, tests, and procedures are appropriate for your individual situation.
The goals of treatment for bow legs are to restore knee joint orientation and a neutral mechanical limb alignment, equalize limb lengths at skeletal maturity, and prevent recurrence. Here are some treatment options that may be recommended:
- Medications and supplements: If an underlying disease is causing bow legs, treating the disease first may correct leg alignment. Medications and supplements may be used as part of the treatment plan.
- Regular exercise: Exercise can help strengthen leg muscles, improve posture and balance, and potentially correct bow legs in young adults. However, there is limited research on exercise correcting the condition in children. Consult with a doctor or physical therapist for guidance on appropriate exercises based on individual symptoms and gait.
- Therapeutic procedures: In cases of mild to moderate knee osteoarthritis with bow legs, a technique called guided growth may be considered.
- The surgical procedure involves placing small metal plates or screws on one side of the bone's growth plate to slow growth on that side, allowing the other side to catch up.
- This helps the bone straighten naturally as the child grows, correcting leg alignment, reducing stress on the knee joint, improving mobility, and potentially slowing the progression of osteoarthritis.
- Health behavior changes: Making lifestyle modifications such as maintaining a healthy weight can help reduce stress on the knees.
It is important to note that these recommendations are general and may vary depending on the individual's specific condition. Always consult with a healthcare professional for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.