Genu varum(bow legs)

Anatomy of knee joint

Deformities of knee jointGenu varum (bow legs)Genu valgum (knock knees)Genu recurvatum (hyperextension of knee)

Genu varumDefinition:Condition where the knees are abnormally

divergent and ankles abnormally approximated.

Etiopathogenesis:unequal growth of the medial and lateral side of the epiphyseal growth plate

Physiological genu varum and genu valgumGenu varum occurs normally in infants. Degree of varus decreases till 18 – 24 months

when the lower limb becomes almost straightThenafter, genu valgus starts appearing,

intensifies reaching its peak by about 4 years and then starts decreasing and by about 7 yrs it gets stabilized with residual valgus of about 5-7 degrees.

Genu varum may occur in adults if this physiological varus fails to correct spontaneously.

Exact cause of physiological genu varum is unknown

Other causes - Rickets- Blount’s disease- Injuries to epiphyseal growth cartilage- Osteoarthritis > rheumatoid arthritis- Ligament injuries- Malunited fractures- Paget’s disease of bone

Clinical featuresPatient usually consults because of cosmetic

problemUsually bilateral If associated with joint instability can lead to

osteoarthritis of medial compartment of knee (pain and stiffness)

Severity measurement: intercondylar distance

InvestigationsDeformity is obvious from external

appearanceRadiograph : to differentiate physiological

genu varum from from rickets, trauma, infection or Blount’s disease.

Treatment

Surgery:

Stapling of the physesHemi-epiphysodesisHigh tibial osteotomy

Ilizarov’s techniqueplating

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