II. Pathophysiology
- Normal finding in the newborn
- Physiologic bowing of the lower extremities
- External rotation of femur
- Internal rotation of tibia
III. Symptoms
- Noted first at walking age
IV. Signs
- Knees bow apart
- Typically symmetric and bilateral
- Measuring degree of Genu Varum
- Child stands with medial malleoli touching
- Measure distance between medial femoral condyles
V. Differential Diagnosis
- Rickets
- Skeletal dysplasia
- Blount's disease
- Obesity-related abnormal growth of medial proximal tibial physis
- Tibial Bowing
- Anterolateral bowing
- Neurofibromatosis association
- Posteromedial bowing
- In utero calcaneovalgus foot (will correct)
- Anterolateral bowing
- High impact sports
- May generate Genu Varum in teens
VI. Management
- No management (bracing, connective bars, Orthotics) needed in most cases
- Surgical osteotomy may be considered in severe, non-resolving cases
VII. Course
- Persistence after age 2 years is atypical
- Often transitions to Genu Valgum (Knock-Knees)
- Occurs between ages 18 months to 3 years
- Corrects spontaneously by ages 6 to 10 years
VIII. Complications
- Premature Osteoarthritis