Angular Deformities of the Lower Extremity in Children

Abstract

Angular deformities of the lower limb in children are a frequent cause of referral to a pediatric orthopaedic surgeon. Two of the most common such conditions are bowleggedness, or genu varum, and knock-knees, or genu valgum, with a further group of angular deformities marked by malalignment at the hip or ankle. A detailed knowledge of physiologic and pathologic alignment and growth of the lower extremity is imperative in determining the individually appropriate treatment of patients. This article discusses the etiology and diagnosis of four angular deformities of the lower limb commonly seen in children, consisting of genu varum, genu valgum, ankle varus, and ankle valgus, as well as strategies for their management, including bracing, guided growth, and osteotomy. Conditions affecting the hip (coxa vara) and rotational alignment of the lower extremity (anteversion/retroversion/tibial torsion), and deformities of the lower extremity in the sagittal plane (genu procurvatum/recurvatum) are beyond the scope of this article, but should be included in the complete evaluation of every patient.

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