Bowlegs and knock knees

1. What is bowlegs? What is genu varum?
Bowleg is also called genu varum; it is an “outward” curving of the legs that occur in most babies and toddlers.  It is normal for babies and toddlers to be bowlegged up to 24 months old.  The legs’ angles then change and 3 to 5 year olds are usually knock-kneed.  Children older than 6 years old normally have the same alignment as adults; which is slightly knock kneed.

2. What is internal tibial torsion?
Internal tibial torsion is a characteristic of many infants. It is a cause of in-toeing. The tibia bones spiral inward between the knees and feet and cause the feet to point toward each other. Internal tibial torsion combines with bowlegs to look more severe to a child’s family than the bowlegs really are. Just as children grow out of bowlegs, they also almost always grow out of internal tibial torsion.

3. What is Blount’s disease? What if my child’s bowlegs persist and worsen after the age of 2?
Children who become more bowlegged instead of less after the age of 2 have infantile Blount’s disease.  Infantile Blount’s disease is a disease of the growth plate at the tibia bone near the knee.  The disease is progressive, so kids with Blount’s disease will become more bowlegged instead of growing out of it.  The afflicted kids are usually heavier and walk younger than other kids.  We can distinguish Blount’s disease from normal bowlegs by examining your child and obtaining x-rays of his/her legs.  We treat Blount’s disease with braces or surgery depending on your child’s age and the severity of the problem.  Blount’s disease is pretty rare, but does happen.

4. What is the treatment for knock knees?
Knock knees, also called genu valgum, rarely need treatment. A few kids have abnormal knock knees that persist after age 6 or seven. These kids will not “grow out of” knock knees. We can distinguish the kids whose legs are abnormal from those that are normal and offer the kids with abnormal knock knees effective treatment. The treatment is easier for the kids and more effective if it is done before they finish growing. It is a surgery called a “guided correction”.


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