Genu varum
Overview
Genu varum (also called bow-leggedness or bandiness), is a deformity marked by medial angulation of the leg in relation to the thigh, an outward bowing of the legs, giving the appearance of a bow. It is also known as bandy-leg, bowleg, bow-leg, and tibia vara. Usually there is an outward curvature of both femur and tibia. "Genu varum" is distinguished from Blount's disease because it involves both the femur and the tibia, while "Blount's disease" affects only the tibia with no femur involvement.
Symptoms
* Knees do not touch when standing with feet together (ankles touching) * Bowing of legs is same on both side of the body (symmetrical) * Bowed legs continue beyond age 3
Causes
If a child is sickly, either with rickets or suffering from any ailment that prevents the due ossification of the bones, or is improperly fed, the bowed condition may remain persistent. Thus the chief cause of this deformity is rickets. Skeletal problems, infection, and tumors can also affect the growth of the leg, sometimes giving rise to a one-sided bow-leggedness. The remaining causes are occupational, especially among jockeys, and from physical trauma, the condition being very likely to supervene after accidents involving the condyles of the femur. Adults with rickets are thought to be bowlegged due to horse back ridding.
Prevention
Prevention involves avoiding the causes of the problem such as: * angled healing of fractures, which can be prevented with proper bone fracture repair * arthritis, which can occasionally be prevented by avoiding repeated overuse or injury to the joints * childhood rickets, which is often caused by a lack of sunlight and low vitamin D intake * injury to the growth plates of the knee
Diagnosis
The first step in diagnosis is for the doctor to examine the legs. When standing or lying down, the affected person's knees are bowed outward. They appear farther apart than normal. An instrument to measure angles, called a goniometer, can be used to determine the abnormal bowing. Joint X-rays can also confirm this condition.
Treatment
Generally, no treatment is required for idiopathic presentation as it is a normal anatomical variant in young children. Treatment is indicated when its persists beyond 3 and half years old, Unilateral presentation, or progressive worsening of the curvature. When caused by rickets, the most important thing is to treat the constitutional disease, at the same time instructing the mother never to place the child on its feet. In many cases this is quite sufficient in itself to effect a cure, but matters can be hastened somewhat by applying splints. When the deformity arises in older patients, either from trauma or occupation, the only treatment is surgery.