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Common childhood orthopedic condition – Bowlegs

• Bowlegged is also known in medical terms as genu varum.
• It is an exaggerated outward bending of the legs.
• The bending is from the knees down and is a condition that can be inherited.
• This condition is common in infants.
• This condition is outgrown by the child as he or she gets older.
• Bowleggedness develops in children as they grow beyond the age of 2.
• Bowleggedness may occur only in one leg in some cases.
• Such a condition poses a larger problem.
• This can be a condition like rickets or Blount’s disease.

What is Rickets?

• Rickets is a condition in which a bone growth problem occurs due to lack of vitamin D or calcium.
• Such a person should have a calcium rich diet.
• This condition can lead to severe bowing of the legs.
• It can lead to muscle pain.
• It can also lead to enlargement of the spleen and liver.

Signs and symptoms of rickets include

• Bone pain
• Dental problems
• Muscle weakness
• Increased tendency for fractures
• Bowed legs
• Knock-knees
• Spinal deformities
• Growth disturbance
• Cupping
• Hypocalcemia
• Tetany
• Craniotabes
• Costochondral swelling
• Harrison’s groove
• Widening of wrist

Types of Rickets

• Nutritional Rickets
• Vitamin D Resistant Rickets
• Vitamin D Dependent Rickets
• Type I
• Type II
• Congenital Rickets
• Newborn Rickets

What is Blount’s disease?

• Blount’s disease is a growth disorder, being a disorder of the tibia.
• It is a growth disorder of shin bone.
• This disorder causes the shin bone to angle inward.
• It is similar to a bowleg.
• “Tibia vara” is the other name for this disease.
• Walter Putnam Blount detected the occurrence of this disease.
• The disease is hence named after him.
• Mau-Nilsonne Syndrome is the other name given for this condition.
• The name comes after C. Mau and H. Nilsonne.
• They were the ones who published early case reports of the condition.
• This condition is known to occur in children, adults and adolescents.

It is also associated with:
• Obesity
• Short stature
• Early walking

Symptoms of Blount’s Disease

Bowing of one or both legs that may:
• Rapidly progressive
• Appear asymmetric
• Occurs just below the knee

Signs and Tests for Diagnosis of Bowlegs

• Physical examination
• The examination reveals that the lower legs are angled inward.
• An x-ray of the knee will confirm the case.
• The lower leg confirms the diagnosis.

Treatment for Bowlegs (Rickets and Blount’s Disease)

1. Rickets
• Rickets is much less common in present time.
• Rickets and the bowlegs that are caused because of this disease are almost always corrected by having vitamin D and calcium rich food.
• Some types of rickets are occurred due to a genetic condition.
• This may require a specialized treatment by an endocrinologist.

2. Blount’s disease
• Children who have severe bowing (prior to their age of 3) may be treated using bracing.
• The bracing may fail.
• Bowing, caused due to the disease, may or may not be detected till the child is older.
• Surgery may be performed.

Surgery may involve:
• Cutting the shin bone.
• Realign it. Sometimes lengthen it.
• In some cases, the growth is of just the outer half of the tibia.
• This can be surgically restricted.
• This procedure is meant to allow the child’s natural growth to act in a way to reverse the bowing process.
• There is another smaller surgery that is most effective in children.
• It is effective for those children with less severe bowing with significant growth remaining.

Vitamin D Prescription Power of Vitamin D The Vitamin D Solution

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