Genu varum

Infobox_Disease
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Caption = X-Ray of the legs in a 2 year old child with rickets
DiseasesDB = 29404
ICD10 = ICD10|Q|68|3|q|65-ICD10|Q|68|5|q|65, ICD10|Q|74|1|q|65
ICD9 = ICD9|755.64 congenital; ICD9|736.42 acquired
ICDO =
OMIM =
MedlinePlus = 001585
eMedicineSubj =
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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.

Childhood

Children until the age of 3 to 4 have a degree of Genu Varum. The child lies on its nurse's knee with the soles of the feet facing one another; the tibia and femur are curved outwards; and, if the limbs are extended, although the ankles are in contact, there is a distinct space between the knee-joints. During the first year of life a gradual change takes place. The knee-joints approach one another; the femur slopes downward and inward towards the knee joints; the tibia become straight; and the sole of the foot faces almost directly downwards.

While these changes are occurring, the bones, which at first consist principally of cartilage, are gradually becoming ossified. By the time a normal child begins to walk the lower limbs are prepared, both by their general direction and by the rigidity of the bones which form them, to support the weight of the body.

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.

Expectations

In most cases persisting after childhood, there is little or no effect on the ability to walk. Due to uneven stress and wear on the knees, however, even milder manifestations can see an accelerated onset of arthritis. Those with bowlegs and a genetic predisposition for developing arthritis will likely start having arthritic symptoms around age 30.

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.

ee also

*Genu valgum
*Varus deformity
*Rickets

External links

* [http://www.kneeguru.co.uk/KNEEnotes/node/1076 The KNEEguru - educational site packed with knee content with sections on genu varum]

References

*1911