Children's Hospital Colorado

Bowed Legs

What is bowed legs?

Bowed legs, also known as genu varum, is a common condition occurring in infants and toddlers. In many cases, this condition corrects itself as a child grows.

A child with bowed legs has a distinct space between his or her lower legs and knees. This may be a result of either one or both of the legs curving outward. Walking often exaggerates this bowed appearance.

What causes bowed legs?

In most cases, bowed legs are caused by the baby’s position while his or her mother was pregnant. Contributing factors also include loose ligaments in the legs, which children eventually outgrow.

Who gets bowed legs?

Many babies are born bowlegged because their legs were folded tightly across their bellies in-utero (during pregnancy inside the mother). Bowed legs usually straighten once babies with this condition start to walk and their legs bear weight. By age 2, most kids grow out of the condition.

Bowleggedness is a condition that is very common in toddlers. Adolescents occasionally have bowed legs and in many of these cases, the child is significantly overweight. The most common diseases that cause bowed legs include: limb length discrepancy, Blounts disease, Rickets, kidney disease or trauma. These diseases need to be evaluated and ruled out in order to find the cause of the condition.

What are signs and symptoms of bowed legs?

"Bowlegged" is a condition when someone stands with the feet and ankles together and the knees are wide apart or do not come together. A child with bowed legs will have a distinct space between their lower legs and knees. This may be a result of either one or both of the legs curving outward.

What tests are used to diagnose bowed legs? 

Orthopedic specialists at Children’s Colorado perform a thorough physical exam of the child’s legs, ankles and feet. If needed, x-rays and blood tests may be taken to rule out more serious causes of bowed legs.

How will my child’s doctor diagnose bowed legs?

The specialist evaluates the child’s leg alignment, keeping in mind that that there is a range of “normal” leg alignment for each age.

The goal is to discover whether the alignment is part of normal development and will improve with time and growth, or if the alignment will get worse. If the diagnosis is a worsening case, the condition may require medical or surgical treatment.

What else could it be?

Bowed legs can also be a presentation of Blount’s disease. Blount’s is a disease in which the abnormal growth in the upper part of the shin bone (tibia) causes the legs to bow. Unlike bowed legs, the bowing with Blount’s disease is progressive. Blount’s disease must be treated with bracing or surgery.

Bowed legs in a toddler could also be caused by Rickets, which is a deficiency of Vitamin D or related to a kidney problem. This rarely occurs in developed countries like the United States because many foods are fortified with Vitamin D, including milk. More commonly, rickets is secondary to a problem with absorbing or metabolizing Vitamin D and will require the involvement of an endocrinologist. This condition may requires surgery when the child gets older to correct the bowing.

How are bowed legs treated?

Generally, bowed legs don't require any special shoes or braces. The bowing should improve as the child grows, typically from 15 to 18 months until 2 years of age. Often the child will then develop knock-knees (where the knees come close together), however, this condition should resolve around the age of 8. If there is an alignment concern that continues through the ages of 7 or 8, a pediatric orthopedic provider should be consulted to determine whether there is a need for treatment.

Why choose Children’s Colorado for your child's bowed legs?

Specialized pediatric experts for your child’s bowed legs
Our team of pediatric experts in the General Orthopedic Program specializes in correcting complex limb deformities and limb-length discrepancies (if one leg is longer than the other, for example), like bowed legs. If your child’s bowed legs do not correct as he or she grows, your primary care doctor may refer you to our General Orthopedic Program at Children's Colorado. This program provides highly skilled care for babies, kids, teens with lower (leg) limb issues. Treatment options vary depending on your child’s unique needs. We work with patients and families to find the best treatment for your child.

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