DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20161068

Bow legs and knock knees: is it physiological or pathological?

Ramagopal Ganavi

Abstract


Knock knees and bow legs are commonly seen pediatric orthopedic problem, as the child grows the knee undergoes sequential changes in the axial development from varus to valgus. Differences in appearance of foot and position of foot while the child is walking as noticed by parents most often reflect variations of normal physiological development. As parents are not aware of normal growth and development of lower-extremity, and desire for normal alignment in their children, they are very much concern and motivated to seek medical advice. Many children are referred unnecessary to orthopedician for treatment of physiological genu varum and genu valgus which is unnecessary and may turn out to be sometimes harmful also. Most parents are happy to be reassured that this children deformity is with normal limits and will disappear. For this the physician should be aware of when to consider as physiological and pathological for which he has to take a detailed history of the problem, perform a detailed examination to rule out pathological causes. So, this article helps us to know when to consider physiological and rule out pathological so as to avoid unnecessary interventions for the child.


Keywords


Genu, Varum, Valgum

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References


Sass P, Hassan G. Lower extremity abnormalities in children. Am Fam Physician. 2003;68(3):461-8.

Staheli LT. Practice of pediatric orthopedics, 2001 William & Wilkins publications, Chapter 6 page 80-81.

Mathew SE, Madhuri V. Clinical tibiofemoral angle in south Indian children. Bone Joint Res. 2013;2:155-61.

Salenius P, Vankka E. The development of the tibiofemoral angle in children. J Bone Joint Surg, 1975;57-A:259-61.

Thompson GH. Genu varum, Genu valgum. In: Behrman RE, Kleigman RM, Jenson HB. Eds, Nelson text book of Paediatrics.17th edn, Saunders, phildelphia; 2004:pp 2264-2268.

Tolo VT, Wood B, Amaral RS. Pediatric orthopedics in primary care. Baltimore. MD; William & Wilkins; 1993:254.

Yoo JH, Choi IH, Cho TJ, Yoo WJ. Development of tibiofemoral angle in Korean children. J Korean Med Sci. 2008;23:714-7.

Heath CH, Staheli LT. Normal limits of knee angle in white children: genu varum and genu valgum. J Pediatr Orthop. 1993;13:259-62

Cheng JC, Chan PS, Chiang SC, Hui PW. Angular and rotational profile of the lower limb in 2,630 Chinese children. J Pediatr Orthop. 1991;11:154-61.

Oginni LM, Badru OS, Sharp CA, Davie MW, Worsfold M. Knee angles and rickets in Nigerian children. J Pediatr Orthop. 2004;24:403-7.

Rahman SA, Badahdah WA. Normal development of the tibiofemoral angle in Saudi children from 2 to 12 years of age. World Appl Sci J. 2011;12:1353-61.

Cahuzac JP, Vardon D, Sales de Gauzy J. Development of the clinical tibiofemoral angle in normal adolescents: a study of 427 normal subjects from 10 to 16 years of age. J Bone Joint Surg. 1995;77-B:729-32.

Saini UC, Bali K, Sheth B, Gahlot N, Gahlot A. Normal development of the knee angle in healthy Indian children: a clinical study of 215 children. J Child Orthop. 2010;4:579-86.

Arazi M, Oğün TC, Memik R. Normal development of the tibiofemoral angle in children:a clinical study of 590 normal subjects from 3 to 17 years of age. J Pediatr Orthop. 2001;21:264-7.

Omololu B, Tella A, Ogunlade SO. Normal values of knee angle, intercondylar and intermalleolar distances in Nigerian children. West Afr J Med. 2003;22:301-4.

Stanley Jones, Sumukh Khandekar, Emmanuel Tolessa Normal Variants of the Lower Limbs in Pediatric Orthopedics International Journal of Clinical Medicine. 2013;4:12-7.

Green WB. Genu varum and Genu valgum in children. differential diagnosis and guidelines for evaluation. Compr Ther. 1996;22-9.