Bowed legs, or genu varum, is a condition where the legs curve outward at the knees while the feet and ankles touch. This can be normal in infants and young children, but if it persists beyond early childhood or appears in adults, it may indicate an underlying condition that requires medical attention.

Common Symptoms

• Visible outward curvature of the legs, especially noticeable when standing with feet together
• Uneven wear on shoes
• Knee pain or discomfort
• Difficulty walking or running
• In severe cases, problems with balance and coordination

Cause & Anatomy

• Physiological bowing: Normal variation in young children that typically corrects itself with growth.
• Blount’s disease: A growth disorder of the shin bone (tibia) causing severe bowing.
• Rickets: A condition caused by vitamin D deficiency, leading to softening and weakening of bones.
• Bone dysplasias: Genetic disorders affecting bone growth and development.
• Arthritis: Degenerative joint disease affecting the knee joints, leading to bowing.
• Trauma or fractures: Improper healing of bone injuries can result in bowed legs.

Anatomy of the Leg:

• Femur: The thigh bone, which can be affected by bowing.
• Tibia and Fibula: The bones of the lower leg, primarily the tibia, can curve outward in bowed legs.
• Knee joint: The alignment of the knee joint is crucial in maintaining straight legs.

Diagnosis

• Physical examination: Assessing the alignment of the legs and the range of motion.
• Imaging tests: X-rays to determine the degree of bowing and identify any underlying bone abnormalities. MRI or CT scans may be used for a detailed view.
• Blood tests: To check for conditions like rickets (vitamin D deficiency).

Prevention

• Adequate nutrition: Ensuring sufficient intake of calcium and vitamin D to support bone health.
• Regular check-ups: Monitoring growth and development in children to catch any abnormalities early.
• Protective measures: Preventing trauma and fractures that could lead to improper bone healing.

Treatment

• Observation: Monitoring the condition in young children, as mild cases often resolve with growth.
• Bracing: Using orthotic devices to guide bone growth in children.
• Medications: For conditions like rickets, supplementation of vitamin D and calcium.
• Physical therapy: Exercises to improve strength and alignment.

Surgery

• Osteotomy: Surgical procedure to correct bone alignment by cutting and realigning the bone.
• Growth modulation: In children, procedures like guided growth can help correct bowing by influencing growth plate activity.
• Joint replacement: In severe cases related to arthritis, knee replacement surgery may be necessary.

Rehabilitation

• Physical therapy: Post-surgical exercises to restore strength, flexibility, and range of motion.
• Gradual return to activity: Slowly resuming normal activities under medical guidance to ensure proper healing.
• Follow-up care: Regular check-ups to monitor progress and prevent recurrence.

FAQ’s

Is bowed legs a common condition?
Mild bowed legs are common in infants and young children and usually correct themselves as the child grows. Persistent or severe cases are less common and may indicate an underlying condition.

When should I seek medical advice for bowed legs?
Seek medical advice if bowing persists beyond early childhood, worsens over time, or is accompanied by pain, difficulty walking, or other symptoms.

Can adults develop bowed legs?
Yes, adults can develop bowed legs due to conditions like arthritis, trauma, or bone disorders.

Are there non-surgical treatments for bowed legs?
Yes, non-surgical treatments include bracing, physical therapy, and medications to address underlying conditions. Surgery is considered for severe or unresponsive cases.

Can bowed legs lead to other health problems?
If left untreated, severe bowed legs can lead to joint pain, arthritis, and difficulty walking, affecting overall mobility and quality of life.