Bowlegs- Causes, Signs, Diagnosis, and Treatment

Introduction:

We are all familiar with how the knees appear when we stand. The knees are aligned in a way to form an almost perfectly straight line with the shin bone when we stand. In rare instances, this proper alignment of the knee bones might be slightly altered to give the legs a bowed appearance. This condition where the knees are far apart from each other abnormally, giving the legs a bowed appearance (knees bent outwards) even when the person stands with their ankles close to each other is known as bowlegs. There is another known abnormality of the knee alignment, which is quite opposite to bowlegs, where the knee bones are closer to each other than normal, giving them a knee-knock appearance.

In this read, we will be discussing the former condition, bowlegs.

What Are Bowlegs?

Bowleg is a condition characterized by the bowed appearance of the legs (knees pointing outwards even when a person stands with their ankles close to each other). This occurs when the knees are misaligned from their correct position. Bowleg is considered normal in newborns until they turn 12 to 18 months old. The legs are bowed usually due to the babies' position in their mother’s womb. Usually, the bow legs disappear when the baby starts to bear weight on its legs while it starts learning to walk or stand. Therefore, medical assistance is required only when a baby shows symptoms and signs of bowlegs after two years of age. In some cases, bowlegs can be congenital, and if this is the case, then such conditions are named congenital genu varum. Whereas in others, bowlegs could imply the presence of any disease like rickets or Blount's disease. Unmanaged bowlegs can lead to complications such as arthritis of the hips and knees.

What Causes Bowlegs?

As mentioned earlier, bowed legs are not abnormal until a baby reaches its second birthday. This is due to the position of the baby inside its mother’s womb, and the legs straighten to a normal position once the baby starts bearing weight on its knees when it learns to walk. When a baby has bowed legs even after two years, then it has to be brought under an orthopedic surgeon’s notice.

In some cases, bowlegs could be due to any underlying health problems, and some of the common causes are discussed below:

1. Blount’s Disease:

• This disease is characterized by abnormal development of the shin bone where the shin bone bends below the knee.

• This condition is usually not noticed until the baby starts walking, and the condition worsens as the child walks.

• It is commonly more evident during adolescence, and the kid experiences more joint problems if left untreated.

• Blount’s disease is also commonly called tibia vara and is more common among females than males.

• This affects many African Americans, and children who are overweight (obesity) are at a higher risk of developing joint problems earlier.

• A child who starts walking earlier than normal is also at a higher risk of developing Blount's disease. The normal age when a child starts walking is between 11 months and 14 months of age.

2. Rickets: Prolonged vitamin D deficiency can lead to softening of the bones and hence cause bowlegs.

3. Paget’s Disease: This is a metabolic disease where the problem occurs with malfunctioning of the breakage and rebuilding process of the bone, which is a part of normal body function. Here, the newly formed bone is not strong enough and hence results in bowlegs. This disease is common among older individuals and has a good prognosis if treated early.

4. Dwarfism:Achondroplasia is a bone growth disorder and it causes a very common type of dwarfism. This condition is usually accompanied by bowlegs.

Some other common causes of bowlegs apart from the above-mentioned diseases are as follows:

• Fluoride poisoning.

• Lead poisoning.

• Fractures that are not healed properly.

• Bone dysplasia or abnormal development of bones.

What Are the Common Signs and Symptoms of Bowlegs?

Bowleg is very evident, and some of the common signs and symptoms of bowlegs are mentioned below:

• Knees that point outwards even when a person stands with their ankles close to each other.

• The asymmetrical appearance of the legs.

How to Diagnose Bowlegs?

Bowleg is very evident. That is, a child’s parent can easily see if their child has a bowleg by the appearance of the child’s legs. However, a doctor can help you with diagnosing the cause and severity of the bowlegs and hence, help you with the treatment.

• The general physician or an orthopedic surgeon can ask for an X-ray to see if there is any abnormality in the bones.

• The doctor might ask the child to stand or walk to physically see abnormalities.

• The doctor might ask for some blood tests to diagnose any causes that lead to bowlegs, such as rickets or Paget's disease.

How to Treat Bowlegs?

Bowlegs do not require any treatment until a baby turns two years of age. If bowlegs persist after two years, then some of the following treatment options help.

• Special shoes.

• Casts.

• Braces.

• The orthopedic surgeon might try some of the above-mentioned treatment measures to correct the abnormality, and if the condition persists even after the above-mentioned treatment, then surgical interventions might be needed to correct the bone abnormalities. Surgical treatments are often done when the kid reaches adolescence.

• Treatments to cure the causes of bowlegs, if present (rickets or Paget's disease).

Treatment of Bow Leg in Adults:

The shape of the bone cannot be changed through exercise, strengthening, stretching, or physical therapy. All these will only help to strengthen the muscles and bones but will not alter the shape. The only way to correct this condition is by performing osteotomy where the bone is cut and straightened.

Bow legs can be fixed only through surgery. Osteotomy should be performed to fix bow legs in adults as well as in children.

Conclusion:

Bowleg, though it causes distress and discomfort to the child and the parents, is not a life-threatening disease, and it shows a great prognosis on early diagnosis and treatment. Often the person with bowlegs can walk properly and does not face any problems with mobility. Untreated bowlegs can cause complications such as arthritis of the knees and hips, and therefore, must be treated early. Bowlegs can be prevented by avoiding rickets by providing a good amount of vitamin D by exposing the child to sunlight, and good nutritious food habits can prevent bowlegs as well as other health problems.