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Bow legs, or genu varum, is a condition where one or both legs curve outward at or below the knees. Common in infants, the deformity typically corrects itself, without intervention, as the child ages.
The main symptom of the bow legs is the physical deformity itself, which becomes most apparent when standing with feet together. In very severe cases, the deformity can result in length discrepancy.
The abnormal alignment of the legs can have a negative impact on balance, which may result in a modified gait. Where the deformity is very significant, it can impact range of motion through the hips and knees.
If left untreated, it is common for people with bow legs to develop pain in the hips, knees and ankles, as a result of uneven stress through the joints.
The causes of bow legs include:
Physiological genu varum: due to the position of the infant in the womb, physiological bowing typically resolves by three years of age.
Blount’s disease: a growth disorder which causes abnormal development of the shin bone at the growth plate. Typically diagnosed in early childhood, the symptoms of Blount’s disease typically worsen over time.
Rickets: a disease caused by bone softening and weakness as a product of vitamn D, calcium or phosphate deficiency.
Bone dysplasias: genetic conditions which affect bone development, e.g., achondroplasia.
While bow legs in infancy will typically correct into later childhood, where caused by an underlying condition, additional treatment may be neccessary. Non-surgical treatment options can include:
Bracing and orthotics: bracing can be used to correctly align the leg in infants and young children to slow or correct abnormal bone growth. Serial casting may be used in a similar fashion in cases of very severe deformity.
Physiotherapy: can be used to strength muscles around the hip and knee to improve alignment and posture, as well as total leg stability.
Diet modification and supplementation: where the cause of bowing can be identified as rickets, supplementary vitamin D and calcium may help to correct bone development.
Surgical treatment options for bow legs include:
Epiphysiodesis: this involves the temporary halting of growth in the healthy tibia to help balance alignment with the bowed limb.
Osteotomy: involves the cutting and realignment of the tibia or femur. The new alignment is secured using plates, screws or a rod during the healing process.To learn more about osteotomy, and what to expect from the procedure, visit our Tibial Osteotomy page.
External fixation: involves the use of an external frame to gradually correct alignment, or where it is neccessary to lengthen the bone at the same time as correcting the alignment.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
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Professor Dr Munjed Al Muderis is an orthopaedic surgeon specialising in osseointegration, hip, knee and trauma surgery. He is a clinical professor at Macquarie University and The Australian School Of Advanced Medicine, a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group.