BOW LEGS AND KNOCK KNEES IN CHILDREN
•Physiological bow legs and knock knees:
• Bow legs in babies and knock knees in 4-year-olds are so
common that they are considered to be normal stages of
When to Worry?
• In the occasional case where, by the age of 10, the
deformity is still marked
• - (i.e. the intercondylar distance is more than 6 cm or
the intermalleolar distance more than 8 cm),
operative correction should be advised.
What to Measure:
Inter Malleolar Distance.
(< 8 cm)
Inter Condylar Distance.
(< 6 cm)
How to Treat?
• Corrective Osteotomy.
• Distal Femoral
• Proximal Tibial.
Pathological Bow leg & Knock Knee.
Disorders which cause distorted epiphyseal and/or
physeal growth may give rise to bow leg or knock
• Skeletal dysplasias.
• The various types of Rickets.
• Injuries of the epiphyseal and physeal growth
• Treat the Primary cause if possible.
• If angulation is severe, operative correction will be
necessary, but it should be deferred until near the
end of growth lest the deformity recur with further
• Progressing Deformity:
• Surgical Correction:
1. Corrective Osteotomy.
2. Elevation of the Epiphysis.
3. Excision of the bony bar & Fat pad placement.
4. Always perform a Fasciotomy to avoid Compartment
5. If Shortening ensues- Perform Lengthening at a later stage.