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Progressive bowing of leg in child. No rickets. What is suggested treatment?

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Orthopaedic Surgeon
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18 month old female, progressive tibial/femoral bowing in one leg only. Bowing is now causing in-toeing (right leg, right foot). We can't figure out what is causing this, as the child does not have rickets and does not appear to have Blount's due to bowing above the knee AND below the knee. 18 month old white female, large for her age. I have seen three doctors about this. They all say nothing can be done until age two. I am concerned about the negative impact her bearing weight on her leg will have on her growth plates, especially the one in the ankle, since she is turning her foot completely inward to walk.
Posted Tue, 22 May 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 9 hours later

Thanks for posting your query.

Progressive bowing of the leg at 18 months of age when rickets ruled out can be a variation in normal appearance. Most of the children are born bow legged physiologically.
Toddlers with this normal variation in appearance of the legs usually begin to improve around the age of 15 to 18 months. By age three the problem has generally resolved without any type of bracing or treatment.

In children under two years of age, it is impossible to distinguish "normal" bowed legs from Blount's Disease. However, children with physiologic genu varum will improve with time while those with Blount's Disease will progressively worsen. By age three, x-ray studies of a child's legs will show the abnormalities of Blount's Disease.

You need not worry about the effect of weight bearing on the growth plates. These conditions are completely treatable after 3 years of age with the help of braces.
During this time, the bones of toddlers are considerably flexible and can be easily bent or corrected.

Please be patient. Only time will tell the proper diagnosis and further treatment is not needed at till two completed years.

I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Please accept my answer in case you do not have further queries.

Wishing you good health.

Dr. Praveen Tayal
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