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Bow Leg Correction: Symptoms, Classification, Diagnosis & Recovery

Bow leggedness, also known as Genu varum is referred to the medial angulation of the tibia and the femur. Recognized with varied terms such as bandiness, tibia vara, and bandy leg, the bow-legged condition is characterized by outwardly bending of the knee and inner inclination of the tibia from the thigh's axis, thereby giving a bow-like appearance to the affected. Blount's disease or bow-legged condition is more common among females than it is in other genders. Besides, most athletes are also seen to be bow legged.

The condition is mostly recognized among children and adolescents and may result from malnutrition, or various diseases such as rickets, that hinder ossification of the bones. Apart from that, physical trauma, as well as other occupational causes may result in the emergence and persistence of the condition. However, irrespective of the cause, bow leg correction is possible with proper treatment and management.

Typically, three varied approaches may be implemented for bow leg correction treatment, which may be interchanged depending on the need of the people.

  • Circular External Fixation: For bowing angles greater than 10°, this procedure is highly appreciated. CEF has been praised for the extreme accuracy and high success rate. The candidates undergoing this procedure are usually able to walk after 24 hours post-surgery. With the use of circular frames for the procedure, a number of deformities can simultaneously be corrected along with bowing.
  • Monolateral External Fixation: For non-osteoporotic bones suffering from bowing of the tibia below 10°, an external frame is used for straightening the bowed legs. The fixation of the frame is performed via the minimally invasive procedure and the candidate is allowed to do regular activities henceforth but refrain from heavy strenuous working.
  • Internal Fixation of the Femur: Extremely helpful for femur bowing, however, the procedure is more invasive than external fixation. It is performed by internally fixating the necessary hardware. The procedure is preferred over external fixation as it interferes with other nerves and femur tissues thereby making movement and locomotion quite difficult.

The procedure for bow leg correction can be distinguished as minimally invasive and complete surgical.

  • Hemiepiphysiodesis Temporary Arrest: The procedure involves clipping one side of the growth plate by using two-point screws fixating a small plate. This restricts the abnormal growth towards any other direction and helps in proper growth and development of the child.
  • Gradual Correction (by the use of external fixators): The procedure involves cutting a part of the affected bone in place of which, an external bone is placed with the help of wires and screw pins. The procedure does not affect the daily activities of the child however, close monitoring is required.
  • Acute Osteotomy: This is a surgical procedure in which, a part of the bone is replaced with plates and fixed with screws, and the cast implanted is kept for a period of 6 months. During this period, the individual is not allowed locomotion.

Recovery post bow leg correction depends on the type of treatment performed on the candidate. Where the non-invasive procedures allow people to walk a day or two after the surgery, the operative treatments take approximately eight to sixteen weeks to completely recover. However, complete recovery after surgical bow leg correction treatment may take up to six months. In most cases, the condition is given time to gradually adjust and straighten as need be.

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