Bowed legs
Bowlegs (genu varum) are among the most common bone issues in the early years of a child’s life, characterized by a noticeable outward curve of the legs that makes the knees appear far apart when standing. In most cases, this is normal and improves with growth, but in some cases, it may indicate a problem that requires evaluation and treatment.
Case Definition
Definition of the Condition
Bowlegs (Genu Varum) is a curvature of the leg bones causing the legs to form an outward arc when standing. Bowing may be physiologically normal during the first two years of a child’s life, but intervention is needed if it persists beyond a certain age or is accompanied by pain or difficulty walking.
Symptoms to Watch For
• Noticeable outward curve of the legs when standing.
• Large gap between the knees when the feet are together.
• Mild pain or difficulty walking in some children.
• Abnormal walking pattern.
• Increasing degree of bowing over time.
• Rapid fatigue during play.
Causes of Bowlegs in Children
• Physiological (normal) bowing in early age.
• Vitamin D or calcium deficiency (rickets).
• Bowing due to Blount Disease.
• Obesity or early weight gain.
• Genetic factors.
• Disorders affecting bone growth.
How It Is Diagnosed
Diagnosis is based on:
• Clinical examination to assess the degree of bowing and child’s movement.
• X-rays to measure the angle of curvature and identify the cause.
• Vitamin D and calcium tests if rickets is suspected.
• Growth monitoring to determine if bowing improves or worsens.
Types and Degrees of Bowing
• Physiological bowing: improves naturally with age.
• Mild bowing: requires only monitoring.
• Moderate bowing: may need supportive treatment or treatment of the underlying cause.
• Pathological bowing: requires clear medical intervention, such as for rickets or Blount Disease.
Treatment Methods
Treatment depends on the cause:
First: Conservative Treatment
• Treat vitamin D and calcium deficiency (if present).
• Monitor growth every 3–6 months.
• Encourage proper physical activity.
• Control weight in children with obesity.
Second: Braces
Used in some cases of Blount Disease or if bowing worsens over time.
Third: Surgery
Indicated only in the following cases:
• Severe bowing that does not improve with age.
• Clear underlying disease such as Blount.
• Impact on walking or daily activities.
• Lack of response to conservative treatment.
Tips for Parents
• No need to worry… most cases improve naturally.
• Avoid forcing the child to walk too early.
• Ensure daily sun exposure.
• Provide a diet rich in calcium and vitamin D.
• Monitor the child’s weight.
• Consult a doctor if bowing persists after age 3 or worsens over time.
Frequently Asked Questions about Bowlegs
We fully understand the importance of having all the necessary information to make informed decisions about your health. So, we have compiled the most frequently asked questions about bowlegs in children and provided clear and reliable answers. We hope this section helps you gain a better understanding of the condition.
Yes, it usually disappears gradually by the age of 2–3 years.
Most children need preventive doses according to the doctor’s recommendations.
It becomes serious if the curvature increases or if there is pain or difficulty walking.
No, it is performed only in severe cases.
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