What are the other Names for this Condition? (Also known as/Synonyms)

• Bowleg
• Congenital Genu Varum
• Pediatric Bowleg

What is Bowed Legs? (Definition/Background Information)

• Bowed Legs is a common childhood condition in which the knees appear wide apart when the child stands with their feet and ankles together. Bowed Legs may affect one or both legs and cause an outward curving of the legs
• Bowed Legs predominantly develop due to positioning of the infant in the mother's womb. The condition start to straighten out, once the child begins to walk and apply weight to the legs
• This usually occurs when the child is between 12 to 18 months old. By the age of 3 to 4 years, the condition should correct itself and appear normal. The condition is also referred to as Genu Varum
• Currently, physiologic Genu Varum does not require any treatment, unless the condition is severe. In case the condition is associated with a medical illness, then the use of braces or a surgery may be necessary
• In most cases, the prognosis of Bowed Legs is excellent, and children do not have any difficulty in walking or using their legs. Although currently, medical research has not established a way of preventing Bowed Legs

Who gets Bowed Legs? (Age and Sex Distribution)

• Bowed Legs may occur in children of all races, ethnic groups, and both genders
• Usually, this condition occurs in toddlers and children who are under the age of 3 years
• But, the condition is also more commonly seen in females and children of African-American descent
• Adolescents occasionally have Bowed Legs. In many of such cases, the child is significantly overweight or obese

What are the Risk Factors for Bowed Legs? (Predisposing Factors)

A vast majority of children are born with Bowed Legs. However, the condition spontaneously resolves after a few years, as the child grows. Children may develop Bow-Leggedness due to certain illnesses or abnormal bone growth and development for various reasons. These include:

• Blount’s disease
• Improperly healed fractures
• Lead or fluoride poisoning
• Rickets disease, caused by a deficiency of vitamin D

However, in many cases, adolescents who are significantly overweight have an increased risk of developing the condition.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Bowed Legs? (Etiology)

The majority of cases of Bowed Legs in children under the age of 2, results from physiologic Genu Varum, which is a bowing of the legs due to a variation in normal leg appearance.

• However, the Bowed Legs start to straighten once the child begins to walk and apply weight to the legs
• This usually occurs when the child is between 12-18 months old
• By the age of 3 to 4 years, Bowed Legs should correct itself and the legs should typically appear normal

Bowed Legs may also be caused by certain injuries or illnesses, such as:

• Abnormal lower limb bone development
• Poorly-healed fractures
• Rickets (a vitamin D deficiency disorder)
• Poisoning by lead or fluoride compounds
• Blount’s disease (a disorder affecting the shin bone)

What are the Signs and Symptoms of Bowed Legs?

The signs and symptoms of Bowed Legs include:

• When the feet and ankles are together as the child stands straight, the knees do not touch each other; or there is a wide gap between them
• The Bowed Legs appear symmetrical on both sides (with respect to the body’s vertical center line)
• Bowed Legs remains evident till or beyond the age of 3 years

Once a child reaches the age of 3 or 4 years old, Bowed Legs has corrected, and the legs usually show a regular or normal appearance.

How is Bowed Legs Diagnosed?

A diagnosis of Bowed Legs may involve:

• Complete physical examination with evaluation of medical history
• X-rays of the legs may be required if:
  • A child is 3 years or older
  • The Bowlegs worsen
  • There is symmetrical bowing of the legs
• A physician may also order a blood test to rule out Blount’s disease or Rickets

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Bowed Legs?

If not properly treated, Bowed Legs may lead to a child eventually developing arthritis in the knees or hips. The condition may also affect the child lifelong creating difficulties in walking or sitting.

How is Bowed Legs Treated?

Currently, there is no treatment required for Congenital Genu Varum, unless the condition is severe. However, it is recommended that children still see a healthcare provider at least once every 6 months. In severe cases of Bowed Legs, the treatment may include the following measures:

• Wearing specialized shoes, braces, or casts
• Surgery may be employed to correct the deformity in adolescents with severe Bowed Legs. The different surgical procedures used may include:
  • Guided growth: Guided growth is a surgical procedure that helps temporarily stop the growth on the healthy side of the shinbone, which gives the abnormal side a chance to continue to grow, resulting in straightening of the leg over time
  • Tibial osteotomy: Tibial osteotomy is an open reduction procedure that involves a controlled surgical break of the tibia (shin bone). Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin. This procedure is performed to correct deformity of the legs

How can Bowed Legs be Prevented?

Current medical research has not established a way of preventing Bowed Legs. However, children who have normal sunlight exposure and the proper amount of vitamin D in their diet reduce the risk for the condition.

What is the Prognosis of Bowed Legs? (Outcomes/Resolutions)

• In most cases, the prognosis of Bowed Legs is excellent, and children do not have any difficulty in walking or in performing one’s daily normal activities
• The risk of developing arthritis in the knees or hips increases if Bowleg is not properly treated

Additional and Relevant Useful Information for Bowed Legs:

The following article link will help you understand one of the possible causes of Bowed Legs:

http://www.dovemed.com/diseases-conditions/rickets/