Symptoms
X Legs can remain asymptomatic for a long time. Especially in childhood, the malposition can often be compensated for well. If there are complaints, these are usually expressed by pain in the knee itself, or, if the cause is there, as pain in the hip or pain in the foot. But even if the X legs remain asymptomatic, a medical examination should always be carried out, since the wear and tear on the joints and the possible long-term consequences are greatly increased by the incorrect loading.
Therapy
The aim of therapy of the X legs in children is to restore the physiological leg axis as far as possible. This reduces the incorrect loads and alleviates the complaints. It is also the only way to prevent permanent joint damage, such as arthrosis.
Conservative therapy
If acute symptoms occur, further stress (such as during sports) should be avoided during this period. To reduce the pain that occurs and to contain any inflammation in the knee joint, drugs from the group of NSAIDs such as ibuprofen or paracetamol can be taken. In acute cases, cold therapy and certain electromedical procedures, such as stimulation current therapy, can also help.
The aim of conservative therapy is always to treat concomitant causes. For example, some sports are more joint-gentle than others, e.g. swimming or cycling are more suitable than playing tennis. If, in addition to the X legs, you are also overweight, you should definitely try to reduce this.
The joints of overweight children are more strained anyway, and if this also coincides with a malposition of the axis, it is easy to understand that the joint damage increases massively. In order to relieve the strain on the joints somewhat, physiotherapy can also be carried out to strengthen the stabilizing muscle groups. Therapy with insoles or night-time splinting is not considered promising for children.
The desired change in the direction of growth or “straightening” cannot usually be achieved. In the case of stronger X legs, it may also make sense to treat the malpositioning surgically.There are mainly two common surgical procedures. In epiphysiodesis, the growth plate, i.e. the part of the bone in which the child’s bone growth mainly takes place, is bent over or destroyed.
This can be done either as a temporary epiphysiodesis, in which growth is only inhibited for a certain time, or as a permanent variant. In this way, for example, an existing leg length difference can be compensated. With X legs, it is thus possible to virtually bypass the growth gap on one side of the leg and thus direct further growth in a straight line.
With the repositioning osteotomy, the malpositioning is directly eliminated by correcting the bone near the joint, either the thigh bone (femur) or the shin bone (tibia). This also ensures that the joint surfaces lie correctly on top of each other again after the operation and further damage is prevented. Both surgical procedures involve the general risks of any operation, such as wound healing disorders, infections, or damage to nerves or blood vessels. Rarely is it also possible that a difference in leg length occurs after the operation, which without appropriate therapy (then of course, in turn, can cause incorrect posture.
