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Genu varum, physiologic bowlegs

  • The lower extremities of newborns and infants commonly have mild to moderate bowing and internal rotation due to in-utero positioning.  The bowed appearance is actually a torsional combination from the external rotation of the hip and the internal tibial torsion.  With the onset of standing and independent walking, the bowing spontaneously corrects.
  • Overweight infants might have persistent bowing. 
  • The typical infant has 15 degrees of Genu Varum (bowleg).

  • None, but the physical deformity may be seen.

  • Unknown

  • On inspection of the knees
  • The distance between the knees with the child supine (lying down) is a clinical measurement of the Genu Varum.
  • An x-ray of the knees should be done if the Genu Varum is severe, to exclude similar conditions.

  • Obesity

  • Treatment is indicated for children older than 2 years in whom there has been no documented improvement with growth.
  • Treatment might include braces to prevent further stretching of ligaments.

  • Physical evaluation

  • Blount's disease (Osteochondrosis deformans) -- marked by angulation at the metaphysis and progressive bowing of the knees, which does not spontaneously resolve.  The growth plate has early closure.  In the infantile form of this condition, there is leg length inequality (q.v.).


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