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Bow Legs in Children

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Why are my child's legs bowed? Is this normal?

Bowing of the legs can be part of the normal physiological development of the child. The deformity has a distinctive outward curvature of the knee and lower leg (Figure 1). As the child becomes older, this normally will improve without treatment.

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The deformity is usually symmetrical and appropriate for the age of the patient. There is no pain or stiffness. The child will have a normal screening process. The infant is born with bowed legs (genu varum). Bowing begins to slowly improve. At about 18 months of age, the leg becomes straight. This will correct itself by the age of 5-6, leaving a slight appearance of knock knee (Figure 2).

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Half of the children correct their bowing earlier and the other half will correct it later. The child will be observed and no treatment is necessary. Give the child time.

Pathological bowing of the legs is due to a disease process and will get worse with time if not treated. Physicians should be concerned if the deformity is severe. If it runs in families, especially short families, or if it occurs on one side of the body. When bow leg is severe, it may result from underlying conditions such as blount's disease.

Blount's Disease
Blount's disease is a pathological condition that can occur in toddlers, as well as in adolescents (Figure 3). Abnormality of the growth plate in the upper part of the tibia causes deformity that is often mistaken for genu varum (bow leg).

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