Bowlegs

Definition

Bowlegs is a condition in which the knees stay wide apart when a person stands with the feet and ankles together. In children under 18 months, it is considered normal.

Alternative Names

Genu varum

Causes, incidence, and risk factors

Infants are born bowlegged because of their folded position in the uterus. The infant's bowed legs begin to straighten once the child starts to walk and the legs begin to bear weight (about 12 to 18 months old).

By around age 3, the child can usually stand with the ankles apart and the knees just touching. If the bowed legs are still present, the child is called bowlegged.

Bowlegs may be caused by illnesses such as:

• Blount's disease
• Bone dysplasias (abnormal development)
• Fractures that do not heal correctly
• Lead or fluoride poisoning
• Rickets, which is caused by a vitamin D deficiency

Symptoms

• Knees do not touch when standing with feet together (ankles touching)
• Bowing of legs is same on both side of the body (symmetrical)
• Bowed legs continue beyond age 3

Signs and tests

A doctor can often diagnose bowlegs by simply looking at the child. The distance between the knees is measured while the child is lying on the back.

Blood tests may be needed to rule out rickets.

X-rays may be needed if:

• The child is 3 years old or older
• The bowing is getting worse
• Bowing is not the same on both sides
• Other test results suggest disease

Treatment

No treatment is recommended for bowlegs unless the condition is extreme. The child should be seen by the health care provider at least every 6 months.

If the condition is severe or the child also has another disease, special shoes, braces, or casts can be tried. It is unclear how well these work.

At times, surgery is performed to correct the deformity in an adolescent with severe bowlegs.

Support Groups

Expectations (prognosis)

In many cases the outcome is good, and there is usually no problem walking.

Complications

Bowlegs that does not go away and is not treated may lead to arthritis in the knees or hips over time.

Calling your health care provider

Call your health care provider if your child shows persistent or worsening bowed legs after age 3.

Prevention

There is no known way to prevent bowlegs, other than to avoid rickets. Make sure your child has normal exposure to sunlight and appropriate levels of vitamin D in the diet.

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References

Canale ST. Osteochondrosis or epiphysitis and other miscellaneous affections. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 29.