Genu varum

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Genu varum
XrayRicketsLegssmall.jpg
X-Ray of the legs in a 2 year old child with rickets
ICD-10 Q68.3-Q68.5, Q74.1
ICD-9 755.64 congenital; 736.42 acquired
DiseasesDB 29404
MedlinePlus 001585

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Genu varum or Blount's disease, commonly referred to as bow-leggedness, 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, with at times an interior bend of the latter bone.

Childhood

At birth all children are more or less bow-legged. 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

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Haloperidol
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Celiac sprue
Genetic Boomerang dysplasia, Hyperostosis corticalis deformans juvenilis, Weismann-netter-stuhl syndrome
Hematologic Hypophosphatasia
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic Achondroplasia, Aortic arch anomaly , Blount disease, Boomerang dysplasia, Caffey disease, Campomelic dysplasia, Fibular hemimelia, Fracture, Hyperostosis corticalis deformans juvenilis, Hypochondroplasia, Kyphomelic dysplasia, Metaphyseal chondrodysplasia , Metaphyseal dysplasia, Multiple epiphyseal dysplasia, Osteoarthritis, Osteofibrous dysplasia, Osteogenesis imperfecta, Osteomalacia, Physical trauma, Pseudoachondroplasia, Rickets, Spondylometaphyseal dysplasia , Weismann-netter-stuhl syndrome
Neurologic No underlying causes
Nutritional/Metabolic Rickets, Vitamin c deficiency
Obstetric/Gynecologic No underlying causes
Oncologic Tumors
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Osteoarthritis, Osteomalacia, Paget's disease
Sexual No underlying causes
Trauma Fracture, Physical trauma, Pseudoachondroplasia
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

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

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.

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