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Children until the age of 3 to 4 have a degree of genu varum. The child sits 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.
Blount's disease is an important differential diagnosis because it causes knee deformities in a similar fashion to rickets namely bow legs or genu varum. Infants with rickets can have bone fractures. This sometimes leads to child abuse allegations.
Knee: genu varum (from Latin genu = knee) — the tibia is turned inward in relation to the femur, resulting in a bowlegged deformity. Ankle: talipes varus (from Latin talus = ankle and pes = foot). A notable subtype is clubfoot or talipes equinovarus, which is where one or both feet are rotated inwards and downwards. [6] [7]
Genu recurvatum is a deformity in the knee joint, so that the knee bends backwards. In this deformity, excessive extension occurs in the tibiofemoral joint. Genu recurvatum is also called knee hyperextension and back knee. This deformity is more common in women [citation needed] and people with familial ligamentous laxity. [2]
In some cases, children with type A deformities will also have an externally rotated femur, which could lead to bowing of the legs (genu varum). Type B — The femur bone is shorter on the proximal end (near the hip) and the defect affects both the femoral head (the ball) and the femoral shaft (the long part of the bone).
Children who develop severe bowing before the age of 3 may be treated with knee ankle foot orthoses. [9] However, bracing may fail, or bowing may not be detected until the child is older. Bracing should be started by 3 years of age. In some cases, surgery may be performed. [10] [2] [11] [8]
Mild genu valgum is diagnosed when a person standing upright with the feet touching also shows the knees touching. It can be seen in children from ages 2 to 5, and is often corrected naturally as children grow. The condition may continue or worsen with age, particularly when it is the result of a disease, such as rickets. [2]
Children and adults with distal 18q- are often small for their age. Many people with distal 18q- have an abnormal response to growth hormone stimulation. Those who have been treated with growth hormone have responded well to the treatment. [6] Microcephaly is also common in people with distal 18q-.