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Knock Knees and Bow Legs in Children
Genu varum (bow legs) and genu valgum (knock knees) are angular knee deformities in children that follow a normal developmental pattern - bow legs are normal from birth to age 2 years, knees straighten by age 2-3, then knock knees peak at age 3-4 years before gradually correcting by age 7-8 - most cases are physiological (normal development) resolving without treatment, but pathological deformities from Blount disease (abnormal growth plate causing progressive bowing), rickets (vitamin D deficiency), or skeletal disorders require treatment with observation, vitamin D supplementation, bracing, or surgery (guided growth with temporary plates or corrective osteotomy) depending on severity and underlying cause.
đWhat is Knock Knees and Bow Legs in Children?
Genu varum (bow legs) and genu valgum (knock knees) are angular knee deformities in children that follow a normal developmental pattern - bow legs are normal from birth to age 2 years, knees straighten by age 2-3, then knock knees peak at age 3-4 years before gradually correcting by age 7-8 - most cases are physiological (normal development) resolving without treatment, but pathological deformities from Blount disease (abnormal growth plate causing progressive bowing), rickets (vitamin D deficiency), or skeletal disorders require treatment with observation, vitamin D supplementation, bracing, or surgery (guided growth with temporary plates or corrective osteotomy) depending on severity and underlying cause.
đŦWhat Causes It?
- Physiological (normal development): bow legs birth to 2 years, knock knees 3-4 years resolving by 7-8 years
- Blount disease (tibia vara): abnormal growth plate development on inner tibia causing progressive bowing
- Rickets (vitamin D deficiency): poor bone mineralization causing soft bones and angular deformities
- Skeletal dysplasias (achondroplasia, hypochondroplasia): genetic bone disorders
- Metabolic bone disease (renal rickets, hypophosphatemic rickets): kidney or metabolic disorders
â ī¸Risk Factors
You may be at higher risk if:
- Obesity in early walking age (increases Blount disease risk)
- African or Hispanic ethnicity (higher Blount disease incidence)
- Early walking (before 10-12 months increases mechanical stress on growth plates)
- Vitamin D deficiency (nutritional rickets - exclusive breastfeeding without supplementation)
- Family history of angular deformities or skeletal dysplasias
đĄī¸Prevention
- âVitamin D supplementation for exclusively breastfed infants (400 IU daily prevents rickets)
- âMaintain healthy weight in toddlers (reduces Blount disease risk)
- âDon't encourage very early walking (before 10-12 months increases stress on growth plates)
- âRegular pediatric checkups monitoring developmental milestones and leg alignment
- âAdequate dietary calcium and vitamin D throughout childhood