valgus

Valgus refers to an angular deformity in which the distal part of a limb deviates laterally away from the midline. In anatomical terms, a valgus deformity causes the angle at a joint to open toward the outside of the limb; the opposite deformity is varus, in which the distal segment angles toward the midline. Valgus can occur at various joints, most commonly in the knee as genu valgum, in the elbow as cubitus valgus, and in the ankle or hindfoot as valgus deformity.

Natural development: mild genu valgum is common in children and often resolves by age 7–8. Persistent or progressive valgus can result from obesity, rickets, osteomalacia, metabolic bone disease, congenital or developmental conditions, post-traumatic malunion, infection, neuromuscular disorders, or skeletal dysplasias.

Diagnosis and assessment: physical examination and observation of gait are used, with measurements such as the femorotibial angle or hip-knee-ankle angle on full-length standing radiographs. Palpation for limb length discrepancy may be performed; CT or MRI is rarely needed.

Treatment and management: mild, asymptomatic valgus in children often requires no treatment and may correct spontaneously. Persistent deformity or functional impairment may be addressed with observation, physical therapy, and bracing. In growing children, guided growth surgery (hemiepiphysiodesis) can gradually tether one side of the growth plate; osteotomy is considered in skeletally mature patients.

Prognosis and implications: most mild cases resolve, but untreated valgus may contribute to altered gait or, in some contexts such as cubitus valgus, complications over time. Management focuses on addressing the deformity's cause and the patient’s functional status.