Tvarus

Tvarus is a term used in some medical languages to describe a varus deformity, an inward angulation of a limb or segment toward the midline. In English-language usage, varus is the standard term, but tvarus may appear in translations or regional medical texts as equivalent to varus. The concept refers to a misalignment where the distal part of a bone or joint is directed medially relative to the proximal part.

Common manifestations include genu varum (knee varus), tibial varus, and hindfoot varus (pes varus). Varus deformities can be present at birth or develop during growth, and may arise from congenital conditions, growth plate disturbances, trauma, neuromuscular disorders, obesity, or postural factors. Clinically, varus deformity appears as bowing or inward deviation with potential gait alterations and medial joint loading.

Diagnosis typically involves a physical examination to assess limb alignment and gait, followed by imaging. Standing long-leg radiographs are commonly used to measure angular deformities and the mechanical axis, with additional imaging as needed to identify underlying causes.

Management is guided by severity, location, age, and etiology. Mild varus in children may be monitored for spontaneous improvement during growth. Interventions can include physical therapy, bracing or orthotics, and close observation. In growing children, guided growth techniques using temporary physeal arrest (for example, hemiepiphysiodesis) can correct deformity over time. In skeletally mature patients or in severe deformities, surgical correction with osteotomy (such as tibial or femoral osteotomy) may be necessary to restore proper alignment. Treating any underlying condition is also important.

Prognosis depends on the cause and degree of deformity, as well as timely intervention. Persistent malalignment can increase the risk of joint degeneration if not addressed. See also varus versus valgus.