Bow Legs is a deformity of the lower legs that presents as an outward bending of the knee and the angling of the leg towards the inside in relation to the axis of the thigh, thereby giving an appearance of an archer’s bow. The condition is sometimes seen in children (physiological genu varum) and they outgrow it after 2 years, but in some individuals, the condition persists into adulthood, or it may be caused by other conditions (pathological genu varum).
Bow Legs are not a medical emergency.
Bow Legs may be of the following types:
In normal anatomy, the knee faces forward with the centre of gravity passing through it so that the bodyweight when standing is evenly distributed on both sides of the lower limb with the knee in the centre. In Bow Legs, there is an outward drifting of the knee and the centre of gravity passes only through the inner side of the knee or sometimes does not even cross it in extreme cases and it results in the bodyweight being loaded on the inner side of the femur and tibia; and when this occurs in childhood, it results in improper growth of the bones and stretching of the ligaments. The improper distribution of weight results in a waddling gait, knee pain, inward turning of toes, and a lateral thrusting of the knees.
Some factors that can result in Bow Legs include:
Factors that increase the risk of Bow Legs include:
The symptoms and signs of Bow Legs include:
No specific investigations are advised for the evaluation of Bow Legs, other than plain radiography which is used for the measurement of the hip knee ankle angle.
A diagnosis of Bow Legs is established based on medical history, and clinical evaluation.
In general, no treatment is required for physiologic genu varum, as the condition corrects itself by the age of 2 years. If the condition persists beyond 3 years, treatment is advised and may include surgical interventions and guided growth.
Surgical interventions for the management of Bow Legs include:
Some measures that can be taken for the management of Bow Legs include:
Some complications associated with Bow Legs include:
The prognosis for Bow Legs is generally very good with proper management and care when initiated at the right time. It also depends on the underlying cause and the general health of the individual.
It is advisable to seek medical attention if a condition of bowing of legs is observed in children and persists beyond the age of 2-3 years.
Hospitalization is not required for the management of Bow Legs.