Diagnosis | Bow legs for baby

Diagnosis

The diagnosis is made on the basis of physical examination and imaging (e.g. X-ray). The pediatrician often recognizes the extent of the bow legs already on the lying or standing child. An interesting possibility, which also allows parents to recognize the progression, is to record the contours of the baby’s legs on a surface or photo documentation during the progression.

This allows parents to see whether the development of the bandy legs is getting stronger, weaker or the same. Furthermore, the doctor can compress the baby’s inner ankles and measure the distance between the knees. With the help of tables the extent of the bandy legs can be determined.

As a further diagnostic measure, an X-ray of the legs can be taken. Here the angle between the thigh and the tibia can be determined again. The degree of bone maturity can also be assessed here.

Therapy

In most of the cases a therapy is not necessary due to the normal development process. However, if the bow-leg position is very pronounced and does not regress to the 3rd year of life as expected, then the use of shoe insoles can be resorted to. These are insoles that are shaped like a wedge.

This wedge is pushed under the outer edge of the foot. The wedge is pushed under the outer edge of the foot, which lifts it up and the knee is tilted towards the inside in a physiological (normal) axis. The height of the wedge depends on how pronounced the bow legs are.

In addition, physiotherapy can be used to strengthen the corresponding muscles. In very pronounced cases a surgical intervention can be performed. This is indicated when it is foreseeable that the knee joint will not straighten naturally and insoles will not achieve sufficient success.

The measure used in this case is the repositioning osteotomy. A bone wedge is removed from the outside of the tibial head. This makes the leg shorter on the outside and the knee tilts outwards, bringing the knee into a more horizontal position. Alternatively, the bone on the inside could also be spread out – here too, the outside of the knee tilts downwards (caudally).