Normal variations - Orthopedics \

Question 1

Bow legs (genu varum) Short note?

Answer 1

» The normal toddler has a broad base gait.
» Many children evolve leg alignment with initially a degree of bowing of the tibiae,
causing the knees to be wide.
» Bow leg can be normal up to age 3 years.
» If persistent consider disease like:
- rickets,
- osteogenesis imperfect
- and Blount disease.

Question 2

Knock-knees (genu valgum)

Answer 2

» The feet are wide apart when standing with the knees held together.
» The intermalleolar distance should be less than 8 cm.
» It is seen in many young children and usually resolves spontaneously.
» Considered normal age range from 2 up to 7 years,
» if persistent consider juvenile idiopathic arthritis.

Question 3

Flat feet (pes planus)

Answer 3

» Toddlers learning to walk usually have flat feet due to:
1. flatness of the medial longitudinal arch
2. and the presence of a fat pad which disappears as the child gets older.
» An arch can usually be demonstrated on:
- standing on tiptoe - or by passively extending the big toe.
» Marked flat feet are common in hypermobility.
» Considered normal up to age 2 years.