Genu Varum in Children: Diagnosis and Treatment

Genu varum is a relatively common finding in children. Physiologic bowing, which is seen most often, has a well-documented favorable natural history. Idiopathic tibia vara is the most common of the pathologic conditions that are associated with bowed legs; treatment strategies vary with the patient’s age and the stage of disease and deformity. Genu varum may also accompany systemic conditions, such as achondroplasia, vitamin D‐resistant rickets, renal osteodystrophy, and osteogenesis imperfecta—all of which can result in short stature. Indications for intervention are not always well defined. A rare disorder, focal fibrocartilaginous dysplasia, usually requires no treatment. Standing radiographs of the entire lower limbs are necessary for surgical planning, as the deformity can sometimes affect the distal femur rather than the proximal tibia. Restoration of the mechanical axis of the limb is the principal goal of treatment; the particular type of internal fixation is of secondary importance. J Am Acad Orthop Surg 1995;3:326-335 Genu varum, known colloquially as bowlegs, is relatively common in children and is a frequent cause of parental concern. In the vast majority of cases, genu varum will correct with growth. A small number of children have pathologic conditions that may result in functional and cosmetic problems if left untreated. In this article, we will review pertinent factors in the assessment of genu varum, associated conditions, and treatment options.