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Knock Knees & Bow Legs


Although infants are born with bowlegs, where the knees appear to "bow" out from the body, the knees tend to straighten out between 18 and 24 months of age. This means that when most children begin to walk, at around 12 months of age, they appear to be bow-legged. Knock knees, on the other hand, are when the knees appear to bend toward each other. If a child has knocked knees, it will be most evident when he or she is around 3 years of age, and will then gradually become less pronounced. By age 7, these children will have attained the normal adult amount of slight knock-knee — 5 to 9 degrees — which they will maintain throughout their lives.

 

1. Bow Legs

Bowlegs are a condition in which the knees stay wide apart when a person stands with the feet and ankles together. In children under 18 months, bowing of legs is considered normal.
Causes
Infants are born bow legged because of their folded position in the uterus. The baby bowed legs begin to straighten once the child starts to walk and the legs begin to bear weight (about 12 to 18 months old). By around age 3, the child can usually stand with the ankles apart and the knees just touching. If the bowed legs are still present, the child is called bowlegged.
Bowlegs may be caused by illnesses such as:

  • Blount's disease
  • Bone dysplasia (abnormal development)
  • Fractures that do not heal correctly
  • Lead or fluoride poisoning
  • Rickets, which is caused by a vitamin D deficiency

Symptoms

  • Knees do not touch when standing with feet together (ankles touching)
  • Bowing of legs is same on both side of the body (symmetrical)
  • Bowed legs continue beyond age 3

Bow legs Treatment
No treatment is recommended for bowlegs in children unless the condition is extreme. The child should be seen by the health care specialist at least every 6 months. If the condition is severe or the child also has another disease, bow leg correction can be done using special shoes, braces, or casts. It is unclear how well these work. At times, surgery is performed to correct the deformity in an adolescent with severe bowlegs.
Outlook (Prognosis)
In many cases the outcome is good, and there is usually no problem walking.
Possible Complications
Bowlegs that does not go away and is not treated may lead to arthritis in the knees or hips over time.
Prevention
There is no known way to prevent bowlegs, other than to avoid rickets. Make sure your child has normal exposure to sunlight and appropriate levels of vitamin D in the diet.

2. Knock Knees

Knock knees is a condition in which the knees touch, but the ankles do not touch. The legs angle inward.
Causes
Infants start out with bowlegs because of their folded position in the uterus. The infant's bowlegs begin to straighten once the child starts to walk (at about 12 to 18 months). By age 3, the child develops knocked knees. When the child stands, the knees touch but the ankles are apart. By puberty, the legs straighten out and most children can stand with the knees and ankles touching (without forcing the position). Knock knees can also develop as a result of a medical problem or disease, such as:

  • Injury of the shinbone (only one leg will be knock-kneed)
  • Osteomyelitis (bone infection)
  • Overweight or obesity
  • Rickets (a disease caused by a lack of vitamin D)

Knock knees Treatment
Knock knees in children are usually not treated. If the problem is still present after age 7, the child may use a night brace, which is attached to a shoe or orthopedic shoe. Surgery may be considered to correct knock knees that persist beyond late childhood and in which the separation between the ankles is severe.
Outlook (Prognosis)
Children normally outgrow knock knees without treatment, unless it is caused by a disease. For cases needing surgery, the procedure provides good cosmetic results.
Possible Complications

  • Difficulty walking (very rare)
  • Self-esteem changes related to cosmetic appearance of knock knees
  • If left untreated, knock knees can lead to early arthritis of the knee

Prevention
There is no known prevention for normal knock knees.

Authored By: Dr. S. V. Santpure

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