What are Bowlegs?
Bowlegs are a condition in which a person’s legs appear bowed out, which means that their knees stay wide apart, even when their ankles are together. Bowlegs is also known as congenital genu varum. Bowlegs can sometimes be a sign of an underlying disease, such as Blount’s disease or rickets and may lead to arthritis in the knees and hips.
Treatment options may include braces, casts, or surgery to correct Bowlegs. Sometimes, kids with bow legs may walk with the toes pointed inward or they may trip a lot and appear clumsy. These problems generally resolve as the child grows. If the condition lasts into the teenage years, it may cause discomfort in the ankles, knees, or hips.
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What are the Causes of Bowlegs?
Babies are born with bow legs because their bones had been slightly twisted when they were growing in the mother’s womb. This is called physiologic bowlegs.
As a child starts walking, the bowing might increase a bit and then get better. In most kids, the outward curving of the legs corrects on its own when they are 4 years of age. The legs might even look curved inward (knock-knees), which is usually straighten by 8 years of age.
Rarely, bow legs can be caused by a more serious medical condition, such as:
- Rickets is a bone growth problem due to lack of vitamin D or calcium and rickets are one of the causes of bow legs. It’s more common in developing countries where children don’t get enough foods fortified with vitamin D. Sometimes rickets can run in families due to a genetic problem that affects how the body uses vitamin D.
- Blount disease is a growth disorder that affects the bones of the legs and Blount disease is one of the causes of bow legs.
- Some conditions may affect bone growth around the knee including injury, infection or a tumor.
How Are Bowlegs Diagnosed?
Some kids might need to see an orthopedic doctor (bone specialist) if:
- The legs are not straightening on their own.
- The legs are bent to different degrees.
An X-ray might be needed to look for Blount disease or rickets. If rickets is suspected, blood tests can help make that diagnosis.
What are the Treatment Options for Bowlegs?
Treatment for bowlegs is usually not recommended for infants and toddlers unless an underlying condition has been identified. Treatment may be recommended if the case of bowlegs is extreme or getting worse. Treatment options include the following:
- A child usually wears a corrective brace during part of the treatment and a Night brace that helps to straighten the position of the legs gradually.
- Casts are used to correct bone abnormalities.
- Surgery to correct bone abnormalities.
- A child with Blount disease might need a brace or surgery.
The Specific treatment for bowlegs will be decided by the physician based on the following:
- The medical history of the child and age.
- The extent of the condition
- The cause of the condition
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Treating bow legs depends on the cause. If it is caused by rickets, your child may simply need to take vitamin D or calcium supplements if the disease is still in its early stages. Sometimes, supplements are enough to strengthen the bones and improve the condition.
Other causes, including more advanced rickets, require surgery. But for mild cases that don’t cause much pain, physical therapy and weight training will help to strengthen the muscles surrounding your leg bones. However, they won’t straighten your bones.
The most common type of surgery used to treat bow legs without significant osteoarthritis, particularly in younger patients, is a high tibial osteotomy. This procedure realigns the tibia by cutting into the bone and reshaping it. This relieves the pressure on your knee. However, if you have bow legs, osteotomy surgery can also help to prevent, or at least delay, the need for total knee replacement surgery in future.
Following a high tibial osteotomy procedure, you will need to wait three to eight months before getting back to your usual level of activity. You will also need to wear a brace for at least a month or two.
Generally, bow legs do not require any special shoes or braces. The bowing should improve as the child grows from 15 to 18 months until about 3 years of age. If there is an alignment concern that continues past 7 or 8 years, parents should consult a pediatric orthopaedic provider to determine whether there is a need for treatment. Bow legs or one bowed leg beyond the age of 3 can indicate a leg length discrepancy. It can also be a sign of a more serious condition, such as rickets or Blount’s disease.
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Frequently Asked Question:
Most infants and toddlers have bow legs from birth whereas Bowlegs in older children are because of Blount disease or another medical condition. Blount disease is more common in kids who:
- Are overweight
- Started walking at an early age
- Have a family member who had the condition
Bowlegs caused by an underlying disease cannot be corrected completely until the underlying disease is treated.
Bowlegs do not cause any pain in the younger child. As the child grows the bowing can lead to discomfort in the hips, knees or ankles because of the abnormal stress that the curved legs have on these joints.
- Blount’s disease
- Rickets
- Paget’s disease
- Bone fractures that haven’t healed properly
- Abnormally developed bones