BOW legs, also known as bandy legs, tibia vara and genu varum, is a deformity marked by the bowing of the lower leg in relation to the thigh bone. It has the appearance of an archer’s bow, hence the name.

When a patient with this condition stands with their ankles together, their knees will be wide apart.

Most babies are born with bow legs due to the position in which they lie in the womb. As a child starts to walk and weight bear, the leg usually straightens. By the age of three, the child should be able to stand with the ankles slightly apart and the knees just touching. If the legs are still bowing by the age of three, this is considered to be genu varum.

Causes

1. Rickets: This is a nutritional disease occurring due to a lack of vitamin D, calcium or phosphate. This deficiency can lead to weak, softened bone and stunted growth. Rickets is most common in children between the ages of six months to two years.

Because children are still growing, they are the ones who are most vulnerable to the condition. At-risk children are those who have an unbalanced diet, those who live in a climate that has little sunlight and those with darker skin tones.

2. Blount’s disease: This disease occurs in young children and adolescents. Its cause is unknown but is thought to be due to the body weight putting pressure on the growth plates, so that the shin bone fails to develop properly. This condition can affect one or both legs and is most common in children of African ancestry.

Other causes include dwarfism, tumours, fractures, Paget’s disease, brittle bone disease, lead and fluoride poisoning, and occupational bow legs which is especially found in jockeys.

Treatment

No treatment is recommended unless the condition is severe. Where treatment is indicated, braces, specialist shoes and casts may be used. Surgery may be considered in extreme cases when the child is an adolescent.

The prognosis in most cases of bow legs is very good and children usually have no problems walking. The main complication tends to be the early onset of osteoarthritis in the hips and knees.

There is no way of preventing bow legs besides avoiding rickets. Ensure exposure to sunlight and encourage a balanced diet with plenty of vitamin D.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293-7119), Mandeville (962-2100), Ocho Rios (974-6339), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.