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Two years old has bowed legs. X-ray showed bending from knee to ankle. Any advice?

Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions

I have a 25 months old baby girl. Her legs are slightly bowed (genu varum) and people can easily see that her walking looks little odd. Funcationally, she is all right. Walks, runs, jums and quite active. We have consulted Paediatric orthopaedician and he took x-ray of legs and wrists. He says, the bending is there but in the allowed range itself. He asked us to come back after 6 more months. No treatment is suggested. The bend is from below knee to ankle. It is slightly more on left leg. Please give your opinion.
Posted Thu, 28 Feb 2013 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 1 hour later
Welcome and Thanks for posting your query.

Bilateral genu varum(Bowed legs) your child having might be due to physiological, blount's disease or rickets.In children with physiologic genu varum, the bowing begins to slowly improve at approximately 18 months of age and continues as the child grows. By ages 3 to 4, the bowing has corrected and the legs typically have a normal appearance.

However, if your doctor notes that one leg is more severely bowed than the other, he or she may recommend an x-ray of the lower legs. An x-ray of your child's legs in the standing position can show Blount's disease or rickets.

As xray of your child is normal, so it seems more to physiological one.That is the reason your orthopaedician asked you to wait for 6 months. After this period if it persist or increases then your child needs further evaluation for blount disease or rickets.

I hope that clears your doubts.

Good luck -- I hope things go well.

Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
Follow-up: Two years old has bowed legs. X-ray showed bending from knee to ankle. Any advice? 26 minutes later
1. But what are the reasons for genu varum? What if it does not get corrected till 3-4 yrs?
2. Are blount and rickets curable?
3.Do we have to go for calipers in future?
4. What can be the effects in future?
5. Though we are satisfied with the pediatric orthopedician we have consulted, is it advisable to take one more opinion?
6. More importantly, do we take a "wait and watch" approach we are following currently or deal with it urgently?
7. Can this be corrected now itself with the surgery?
8. In which surgery is a solution for genu varum?
Answered by Dr. Saurabh Gupta 5 hours later
Thanks for your query again

These are the answers for the above questions-
*In most children under 2 years old, bowing of the legs is simply a normal variation in leg appearance. This type of bowing is known as physiologic genu varum.If it is not corrected till 3-4 yrs means it is pathological one.
*Blount and Rickets are curable.
*In rare instances, physiologic genu varum in the toddler will not completely resolve and during adolescence, the bowing may cause the child and family to have cosmetic concerns.
*Paediatric orthopaedician you have consulted seems to be correct in his opinion.If you are in doubt you can take one more opinion.
*You can go for wait and watch approach which you are follow currently.
*Surgical treatment is not indicated at this stage.
*If it is due to Blount's disease and bowing continues to progress in a child with infantile Blount's disease despite the use of a brace, surgery will be needed by the age of 4 years. Surgery may stop further worsening and prevent permanent damage to the growth area of the shinbone.
If it is due to Rickets. Surgery may also be needed for children with rickets whose deformities persist despite proper management with medications.

I hope this is helpful to you.

Wishing your child good health...
Dr Saurabh Gupta
Above answer was peer-reviewed by
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