Causes for bow legs
In most cases, malpositions of the leg axes are congenital and appear already in childhood/adolescence. If left untreated, this malposition of the leg axes is more likely to lead to generalized arthrosis the earlier it occurs. It is also possible for bow legs to develop due to tears in the meniscus (articular cartilage disc), making it necessary to remove it surgically.
The subsequent absence of the outer meniscus causes the malposition “bow legs”. This form of leg axis malalignment is ten times more frequent than the knock-knees malalignment. Leg axis malpositions caused by fractures of the thigh or lower leg, as well as the joint surfaces or the knee joint are also common directly, since these can lead to a different leg axis position during healing.
Diagnostics
The leg axis malpositions are best detected in a clinical examination by an experienced physician, as well as by an X-ray of the entire leg, so that a surgical reconstruction of the main load axis is possible. The decisive factor here is how intact the part of the joint that is then more heavily loaded due to the shifting of the main load is. If there is already advanced arthrosis in all sections of the joint, correction of the leg axis is not indicated.
Since bow legs still “grow out” in infancy, no therapy is necessary here. However, the course of the disease must be observed. These controls must be objectively comparable through reproducible measured values.
This can be achieved by photo documentation, outline drawings, measurements of knee distances with feet standing together or by repeated x-rays. Surgical interventions are possible in the form of epiphysenodeses, but they must be carefully weighed against the possible complications and side effects. If the affected person has a knee-jointed foot for compensation, this must also be treated. This is usually done by straightening the foot by means of a shoe insole with a raised inner edge (longitudinal arch support). The additional load on the knee joint, which is mainly shifted to the inside of the knee, can be achieved by elevated soles on the outside.
