Bowing leg (Varus knee) - DRHC Dubai Pediatric Orthopedic Clinic

Common condition where both legs curve toward outside at the knees site and both feet get closer to each other. Infants and toddlers usually have bowing legs sometimes older kids have it too. Usually there are no symptoms just the parents are worried about the shape of the legs and the way the kids are walking.

Bowing legs usually do not affect a child’s ability to crawl, walk, or run. As the child starts walking, the bowing may increase for a while and then improve. Increased weight and early walking (before 1 year of age) may predispose a child to leg bowing. Most of the time, it’s a self-limited condition that resolves without any treatment.

However, a visit to an orthopedic clinic is recommended if:

• The bowing is asymmetric (not the same varus degree in each knee).
• The bowing does not correct itself by age 3 years.
• There are symptoms like pain, limping, weakness, or problems with running or walking.

Causes of Bowing Legs

Bowing legs might be physiological (resolves on its own) or pathological. The most common reasons for pathological bowing legs are Rickets and Blount’s disease.

• Rickets: This is a condition caused by defective mineralization of cartilage in the epiphyseal growth plates due to vitamin D deficiency. Reasons for vitamin D deficiency include poor diet and starvation, poor sun exposure, malabsorption, chronic kidney disease, and genetic diseases (resistant vitamin D deficiency). Bowing legs from Rickets can be accompanied by muscle weakness, poor growth, bone and joint pain, difficulty walking, kyphosis, and sometimes even fractures. Treatment for Rickets is vitamin D supplementation.
• Infantile Blount’s Disease: This is a progressive pathological bowing of the legs centered at the tibia in children aged 2 to 5 years. It is bilateral in 50% of cases and the main cause is mechanical overload in genetically susceptible kids, with the same risk factors as physiological bowing (overweight and early walker).

Treatment Options

At DRHC Dubai, we offer a range of treatments for bowing legs:

• Bracing: For mild degrees of bowing and children less than 3 years old, we use KAFO orthosis.
• Surgery: For children older than 3 years and higher degrees of bowing with Blount disease, we perform proximal tibia/fibula valgus osteotomy, growth modulation, or physical bar resection.

By understanding the complexities of pediatric bowing legs, we can better tailor treatments to each patient’s unique needs and improve their quality of life. To consult with our pediatric orthopedic specialist at DRHC, Dubai Healthcare City branch, you can call at +97142798200.