282:
223:
may also have genetic causes, occasionally called resistant rickets. Rickets usually causes bone deformities in all four extremities. Genu varum may resolve spontaneously with modification of life style activities or after receiving medical treatment. Some deformities do not correct spontaneously and need surgical intervention especially if they are severe and causing gait difficulties. The main surgical modality used to treat genu varum arising from rickets is guided growth surgery, also known as growth modulation surgery.
305:
256:
521:
235:
disease. Blount's disease in this age is very risky because sometimes it is not detected and it passes to the second type of Blount's disease. The second type of Blount's disease is found mostly in older children and in teenagers, sometimes in one leg and sometimes in both; the patient's age determines how severe the diagnosis is.
54:
246:
are a diverse group of genetic bone diseases or genetic skeletal dysplasias that manifest in generalized bone deformities involving the extremities and the spine. Bow legs or genu varum is one of these deformities. The characteristic bone X-ray survey findings are important to confirm the diagnosis.
382:
Treatment for children with Blount's disease is typically braces but surgery may also be necessary. In children guided growth surgery is used to gradually correct/straighten the bow legs. For teenagers osteotomy or bone cutting is often used to correct the bone deformity. The operation consists of
222:
is an important cause of childhood genu varum or bow legs in some parts of the world. Nutritional rickets is due to unhealthy life style habits as insufficient exposure to sun light which is the main source of vitamin D. Insufficient dietary intake of calcium is another contributing factor. Rickets
234:
is a deformity in the legs, mostly from the knees to the ankles. The affected bone curves in or out and forms the usual "archers bow" which can also be called bow-legs. There are two types of Blount's disease. The first type is
Infantile: this means that children under four are diagnosed with this
369:
usually causes bone deformities in all four extremities. Genu varum may resolve spontaneously with modification of lifestyle activities or after receiving medical treatment. Some deformities do not correct spontaneously and need surgical intervention especially if they are severe and causing gait
186:
are curved outwards; and, if the limbs are extended, although the ankles are in contact, there is a distinct space between the knee-joints. During the first year of life, a gradual change takes place. The knee-joints approach one another; the
1193:
856:"Does measurement of the anatomic axis consistently predict hip-knee-ankle angle (HKA) for knee alignment studies in osteoarthritis? Analysis of long limb radiographs from the multicenter osteoarthritis (MOST) study"
1186:
1099:
1076:
403:
In most cases persisting after childhood, there is little or no effect on the ability to walk. Due to uneven stress and wear on the knees, however, even milder manifestations can see an accelerated onset of
1179:
342:, at the same time instructing the care-giver never to place the child on their feet. In many cases, this is quite sufficient in itself to effect a cure, but matters can be hastened somewhat by applying
210:. By the time a normal child begins to walk, the lower limbs are prepared, both by their general direction and by the rigidity of the bones which form them, to support the weight of the body.
383:
removing a piece of tibia, breaking the fibula and straightening out the bone; there is also a choice of elongating the legs. If not treated early enough, the condition worsens quickly.
654:
740:"Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study"
395:
including genu varum. Yet, this treatment is associated with a high incidence of recurrence and repeated surgeries may be needed to maintain proper bone alignment.
1875:
556:
Creo, AL; Thacher, TD; Pettifor, JM; Strand, MA; Fischer, PR (6 December 2016). "Nutritional rickets around the world: an update. Paediatr Int Child Health".
142:
or any other ailment that prevents ossification of the bones or is improperly fed, the bowed condition may persist. Thus the chief cause of this deformity is
154:
can also affect the growth of the leg, sometimes giving rise to a one-sided bow-leggedness. The remaining causes are occupational, especially among
1171:
680:
281:
914:
Sabharwal, Sanjeev; Zhao, Caixia (2009). "The Hip-Knee-Ankle Angle in
Children: Reference Values Based on a Full-Length Standing Radiograph".
604:"Growth modulation for knee coronal plane deformities in children with nutritional rickets: A prospective series with treatment algorithm"
541:
1773:
658:
536:
1266:
178:
Children until the age of 3 to 4 have a degree of genu varum. The child sits with the soles of the feet facing one another; the
111:
1880:
1714:
699:"A systematized approach to radiographic assessment of commonly seen genetic bone diseases in children: A pictorial review"
797:
Cherian, Jeffrey J.; Kapadia, Bhaveen H.; Banerjee, Samik; Jauregui, Julio J.; Issa, Kimona; Mont, Michael A. (2014).
1201:
320:
presentation as it is a normal anatomical variant in young children. Treatment is indicated when it persists beyond
1668:
1387:
391:
Guided growth surgery in children is widely used to achieve gradual correction of knee deformities arising from
334:
years old. In the case of unilateral presentation or progressive worsening of the curvature, when caused by
1503:
1206:
602:
EL-Sobky, TA; Samir, S; Baraka, MM; Fayyad, TA; Mahran, MA; Aly, AS; Amen, J; Mahmoud, S (1 January 2020).
1673:
1392:
1222:
1210:
1704:
697:
EL-Sobky, TA; Shawky, RM; Sakr, HM; Elsayed, SM; Elsayed, NS; Ragheb, SG; Gamal, R (15 November 2017).
1758:
1678:
854:
Sheehy, L.; Felson, D.; Zhang, Y.; Niu, J.; Lam, Y.-M.; Segal, N.; Lynch, J.; Cooke, T.D.V. (2011).
275:. It is normally between 1.0° and 1.5° of varus in adults. Normal ranges are different in children.
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20:
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Valgus osteotomy. The black line is the mechanical axis. This process may be done to correct a
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One or more of the preceding sentences incorporates text from a publication now in the
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8:
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1103:
442:
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231:
998:
799:"Mechanical, Anatomical, and Kinematic Axis in TKA: Concepts and Practical Applications"
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While these changes are occurring, the bones, which at first consist principally of
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difficulties. The main surgical modality used to treat genu varum arising from
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814:
271:, which is an angle between the femoral mechanical axis and the center of the
71:
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Reviewed by members of POSNA (Pediatric
Orthopaedic Society of North America)
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879:
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765:
756:
532:
527:
162:, the condition being very likely to supervene after accidents involving the
119:
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545:. Vol. 4 (11th ed.). Cambridge University Press. pp. 343–344.
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is guided growth surgery, also known as growth modulation surgery.
267:, the degree of varus or valgus deformity can be quantified by the
207:
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371:
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351:
339:
335:
219:
143:
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27:
1080:
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118:'s axis, giving the limb overall the appearance of an archer's
962:"Update on guided growth concepts around the knee in children"
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188:
183:
179:
167:
151:
127:
115:
738:
W-Dahl, Annette; Toksvig-Larsen, Sören; Roos, Ewa M (2009).
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346:. When the deformity arises in older patients, either from
196:
103:
338:, the most important thing is to treat the constitutional
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1322:
1235:
696:
601:
555:
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191:
slopes downward and inward towards the knee joints; the
468:
Journal of the
American Academy of Orthopaedic Surgeons
122:. Usually medial angulation of both lower limb bones (
916:
The
Journal of Bone and Joint Surgery, American Volume
16:
Varus deformity marked by (outward) bowing at the knee
1058:
853:
61:
X-Ray of the legs in a 2 year old child with rickets
26:"Bow-leg" redirects here. For the robotic leg, see
790:
464:"Genu Varum in Children: Diagnosis and Treatment"
1867:
909:
907:
653:Shriner's, Hospital for Children – Houston, TX.
847:
350:or occupation, the only permanent treatment is
19:"Bow legs" redirects here. For other uses, see
1876:Congenital disorders of musculoskeletal system
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955:
953:
913:
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1051:. American Academy of Orthopaedic Surgeons.
679:: CS1 maint: multiple names: authors list (
803:Current Reviews in Musculoskeletal Medicine
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316:Generally, no treatment is required for
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549:
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1175:
509:
462:Brooks WC, Gross RH (November 1995).
377:
195:become straight, and the sole of the
1715:Greig cephalopolysyndactyly syndrome
1024:The Lecturio Medical Concept Library
226:
13:
1205:malformations and deformations of
996:
608:JAAOS: Global Research and Reviews
138:If a child is sickly, either with
102:marked by (outward) bowing at the
14:
1892:
1041:
199:faces almost directly downwards.
519:
480:10.5435/00124635-199511000-00003
280:
1388:Congenital patellar dislocation
1267:Wallis–Zieff–Goldblatt syndrome
1012:
990:
968:. S1877-0568 (19): S171–S180.
646:
621:10.5435/JAAOSGlobal-D-19-00009
455:
1:
744:BMC Musculoskeletal Disorders
570:10.1080/20469047.2016.1248170
448:
106:, which means that the lower
860:Osteoarthritis and Cartilage
398:
361:
358:bracing can provide relief.
299:
250:
173:
7:
1881:Knee injuries and disorders
1674:Oto-palato-digital syndrome
1669:Hallermann–Streiff syndrome
1393:Congenital knee dislocation
1211:musculoskeletal abnormality
411:
10:
1897:
1705:Craniodiaphyseal dysplasia
975:10.1016/j.otsr.2019.04.025
872:10.1016/j.joca.2010.09.011
213:
25:
18:
1839:
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1530:reduction deficits / limb
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966:Orthop Traumatol Surg Res
815:10.1007/s12178-014-9218-y
558:Paediatr Int Child Health
206:, are gradually becoming
133:
65:
60:
51:
43:
38:
1504:Cenani–Lenz syndactylism
1257:Cleidocranial dysostosis
757:10.1186/1471-2474-10-154
703:J Musculoskelet Surg Res
265:projectional radiography
21:Bowlegs (disambiguation)
1651:Craniofacial dysostosis
716:10.4103/jmsr.jmsr_28_17
542:Encyclopædia Britannica
1207:musculoskeletal system
313:
260:
1759:Klippel–Feil syndrome
393:Osteochondrodysplasia
387:Osteochondrodysplasia
307:
259:Hip-knee-ankle angle.
258:
244:Osteochondrodysplasia
239:Osteochondrodysplasia
146:. Skeletal problems,
114:) in relation to the
1769:Spina bifida occulta
1285:Madelung's deformity
1262:Sprengel's deformity
960:Journeau, P (2020).
928:10.2106/JBJS.I.00015
661:on November 26, 2011
288:Hip-knee-ankle angle
269:hip-knee-ankle angle
1587:RAPADILINO syndrome
443:Knee osteoarthritis
292:prediction interval
1449:Rocker bottom foot
1146:External resources
999:"Blount's Disease"
655:"Blount's Disease"
314:
261:
110:is angled inward (
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922:(10): 2461–2468.
290:by age, with 95%
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33:Medical condition
1888:
1831:Pectus carinatum
1826:Pectus excavatum
1789:
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1747:Spinal curvature
1739:Vertebral column
1659:Crouzon syndrome
1623:Craniosynostosis
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657:. Archived from
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227:Blount's disease
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1582:Larsen syndrome
1570:multiple joints
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1378:Genu recurvatum
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1331:Hip dislocation
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100:varus deformity
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1720:Plagiocephaly
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1664:Hypertelorism
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1631:Scaphocephaly
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1514:Brachydactyly
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1335:Hip dysplasia
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1695:Macrocephaly
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1537:Acheiropodia
1509:Ectrodactyly
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1295:Oligodactyly
1290:Clinodactyly
1219:Appendicular
1153:
1129:
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1049:"Bowed Legs"
1027:. Retrieved
1023:
1020:"Genu Varum"
1014:
1002:. Retrieved
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1725:Saddle nose
1492:Webbed toes
1483:Polydactyly
1368:Genu valgum
1300:Polydactyly
1155:MedlinePlus
1004:October 28,
665:October 28,
418:Genu valgum
356:orthopaedic
273:ankle joint
158:, and from
80:Genu varum
72:Orthopædics
44:Other names
1870:Categories
1700:Platybasia
1636:Oxycephaly
1549:Phocomelia
1543:Ectromelia
1519:Stub thumb
1487:Syndactyly
1454:Hammer toe
1423:Pigeon toe
1373:Genu varum
1345:Coxa valga
1203:Congenital
1131:DiseasesDB
750:(1): 154.
449:References
318:idiopathic
96:tibia vara
39:Genu varum
1752:Scoliosis
1559:Hemimelia
1444:Pes cavus
1437:Flat feet
1418:Club foot
1350:Coxa vara
936:0021-9355
880:1063-4584
823:1935-973X
766:1471-2474
709:(2): 25.
438:Knee pain
406:arthritis
399:Prognosis
300:Treatment
251:Diagnosis
204:cartilage
174:Childhood
148:infection
92:bandy-leg
88:bandiness
67:Specialty
1802:Cervical
1249:shoulder
1245:clavicle
1227:dysmelia
1115:acquired
984:31669550
944:19797583
898:20950695
841:24671469
784:19995425
725:79825711
675:cite web
640:32159063
578:27922335
496:36449933
488:10790671
412:See also
208:ossified
164:condyles
112:medially
1817:sternum
1125:D056305
1029:23 July
889:3038654
832:4092202
775:2796991
631:7028784
586:6146424
537:Bow-Leg
530::
501:23 July
433:Rickets
372:rickets
367:Rickets
362:Rickets
352:surgery
344:splints
340:disease
336:rickets
329:⁄
220:rickets
214:Rickets
166:of the
156:jockeys
144:rickets
140:rickets
98:) is a
28:Bow Leg
1840:other:
1554:Amelia
1431:valgus
1160:001585
1113:736.42
1109:755.64
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354:, but
348:trauma
152:tumors
150:, and
134:Causes
124:fibula
94:, and
1807:Bifid
1688:other
1605:Axial
1412:varus
1136:29404
1094:Q74.1
1090:Q68.5
1086:Q68.3
721:S2CID
582:S2CID
492:S2CID
193:tibia
189:femur
184:femur
180:tibia
168:femur
128:tibia
116:thigh
1793:ribs
1360:knee
1236:Arms
1223:limb
1120:MeSH
1104:9-CM
1031:2021
1006:2011
980:PMID
940:PMID
932:ISSN
894:PMID
876:ISSN
837:PMID
819:ISSN
780:PMID
762:ISSN
681:link
667:2011
636:PMID
574:PMID
503:2021
484:PMID
197:foot
182:and
126:and
104:knee
1323:hip
1314:Leg
1100:ICD
1077:ICD
970:doi
924:doi
884:PMC
868:doi
827:PMC
811:doi
770:PMC
752:doi
711:doi
626:PMC
616:doi
566:doi
539:".
476:doi
263:On
120:bow
108:leg
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