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    Genu Valgus Genu Varus

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    athaya fadhillah
    This document discusses genu valgus (knock knees) and genu varus (bowed legs). It notes that bowing is normal in infants but usually corrects by age 2-3, when mild genu valgus of 10-12 degrees develops. Genu varus may persist and be caused by ligament laxity, Blount's disease, or other conditions. Examination involves measuring alignment and ruling out underlying bone diseases. Intermalleolar distance greater than 3.5 inches in older children warrants further investigation including x-rays to check for deformities. Referral is recommended for persistent or asymmetric bowing, short stature, or other abnormalities.

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    Genu Valgus Genu Varus

    Uploaded by

    athaya fadhillah
    243 views17 pages
    This document discusses genu valgus (knock knees) and genu varus (bowed legs). It notes that bowing is normal in infants but usually corrects by age 2-3, when mild genu valgus of 10-12 degrees develops. Genu varus may persist and be caused by ligament laxity, Blount's disease, or other conditions. Examination involves measuring alignment and ruling out underlying bone diseases. Intermalleolar distance greater than 3.5 inches in older children warrants further investigation including x-rays to check for deformities. Referral is recommended for persistent or asymmetric bowing, short stature, or other abnormalities.

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    This document discusses genu valgus (knock knees) and genu varus (bowed legs). It notes that bowing is normal in infants but usually corrects by age 2-3, when mild genu valgus of 10-12 degrees develops. Genu varus may persist and be caused by ligament laxity, Blount's disease, or other conditions. Examination involves measuring alignment and ruling out underlying bone diseases. Intermalleolar distance greater than 3.5 inches in older children warrants further investigation including x-rays to check for deformities. Referral is recommended for persistent or asymmetric bowing, short stature, or other abnormalities.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    243 views17 pages

    Genu Valgus Genu Varus

    Uploaded by

    athaya fadhillah
    This document discusses genu valgus (knock knees) and genu varus (bowed legs). It notes that bowing is normal in infants but usually corrects by age 2-3, when mild genu valgus of 10-12 degrees develops. Genu varus may persist and be caused by ligament laxity, Blount's disease, or other conditions. Examination involves measuring alignment and ruling out underlying bone diseases. Intermalleolar distance greater than 3.5 inches in older children warrants further investigation including x-rays to check for deformities. Referral is recommended for persistent or asymmetric bowing, short stature, or other abnormalities.

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    GENU VALGUS & GENU VARUS

    Natural History of normal evolution of the


    alignment of the lower limbs

    Bowlegs in new born and infant


    With medial tibial torsion = fetal position

    Becomes straight by 18/12

    By 2 or 3 genu valgus develop (avg. 12°)

    By 7 spontaneous correction
    To the normal of adult valgus ( 8°♀ and 7°♂)
    Persistent genu varum

    • Worried parents

    • About 3 years old +bow legs +mild lateral thrust at


    the knees + in-toeing

    • Assessment:
    - History
    - etiologic factors
    Examination
    • Height

    • See ( front, back & side)


    • Measure
     IC distance,
     lateral thigh-leg angle,
     center of gravity

    • Site of varus
    Causes
    • Lateral ligament laxity
    • Blount’s disease
    • Congenital pseudoarthrosis of tibia
    • Coxa vara
    In ligamentous laxity notelat.Widening In Blount angulation at med.tib
    Of knee joints metaphysis
    In cong. Pseudarthrosis of tibia,the In coxa vara ,angulation at the neck shaft
    angulation is in the distal ⅓ level
    • Gait: intoeing, lateral thrust-the fibular head and
    upper tibia shift laterally in Blount due to laxity and
    incompetence of the lat. Collat. Lig.
    • Stability
    • Symmetry
    • Level of fibular head, normally at the level
    of the upper tibial growth plate, while it is proximal
    in Blount, cong.longitudinal dificiency of the tibia
    and achondroplasia
    X-ray

    • 3 years and older


    • Getting worse
    • Abnormal site of
    angulation
    • Large physis and
    epiphysis
    • History – taruma, infection,
    possible metal intoxication(lead or
    floride)

    Metaphysial/diaphysial
    angle ≥ 18°
    Finding

    • Metaphysis, thick and frayed


    in rickets

    • In physiologic genu
    varum no intrinsic bone
    disease, gentle curve, medial
    cortices thickening, horizontal
    joint lines of the knee & ankle are
    tilted medially
    Knock Knees / Genu Valgum

    • Legs are bowed


    inwards in the
    standing position.
    Bowing occurs at or
    around the knee. On
    standing with knees
    together, the feet are
    far apart.
    Investigations 1
    • Measurement of intermalleolar distance. i.e
    Distance between two malleoli when the knees
    are gently touching with legs in adduction.
    • Up to 3 and a half inches (9 centimeters) with
    child lying down is acceptable.
    • 75% of children aged 2 - 4 years have some
    degree of intermalleolar separation.
    Investigations2
    • Intermalleolar separation under 3 inches is
    normal at any age.
    • Periodic observation and measurement if less
    than 3.5 inches.
    • If > 3.5 inches, need AP X-Ray with both legs
    on same film for knee deformity, hip and ankle
    joints and view of both long bones.
    Indicators of Serious Disease
    • Pronounced asymmetry
    • Short stature
    • Other skeletal
    abnormalities
    • Intermalleolar
    separation greater than
    3.5 inches
    Aetiology

    • Developmental
    • Miscellaneous syndromes e.g Rickets (Alk Phos
    raised, with x-ray changes)
    • Rare Genetic disorders e.g Cohen Syndrome
    • Nutritional conditions e.g Vitamin C deficiency
    • Autoimmune e.g RA
    • Degenerative e.g OA
    When to refer
    • Age > 7 with knock knee
    • Unilateral problem i.e Asymmetry of legs
    • Intermalleolar distance > 3.5 inches (9 cms)
    • Associated symptoms e.g Pain, Limp

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