bowleggedness

Bowleggedness, medically known as genu varum, is a condition in which the knees stay apart while the ankles touch when standing with the feet together. It is common in newborns and early childhood, and mild bowing often corrects as a child grows. When bowing persists beyond the preschool years or is associated with pain, asymmetry, or gait problems, medical evaluation is appropriate.

Causes can be physiological or pathological. Physiological bowing typically appears in the first year of life and gradually improves by age 2 to 4 without intervention. Pathological causes include nutritional rickets (often vitamin D deficiency), Blount’s disease (growth disturbance of the proximal tibia), skeletal dysplasias, osteoarthritis, trauma, infection, and certain neuromuscular or metabolic disorders. Obesity can contribute to or exacerbate bowing in some children.

Diagnosis relies on physical examination and measurements of leg alignment, such as the tibiofemoral angle or intermalleolar distance. Imaging, usually plain radiographs, is used when bowing is severe, asymmetric, persists after early childhood, or raises concern for an underlying disorder.

Treatment depends on the cause and severity. Physiological bowing generally requires no treatment beyond observation. Addressing underlying conditions (e.g., vitamin D repletion for rickets, weight management) is essential. Orthotic bracing may be used for some conditions to guide growth. In persistent or progressive cases, especially Blount’s disease, surgical options such as guided growth procedures or osteotomies may be considered to realign the limb.

Prognosis varies with the cause; most benign bowing in children resolves with growth, while untreated pathological bowing may lead to future joint problems or deformity. Epidemiology is variable, with higher risk observed in certain populations and in association with obesity or growth disturbances.