BOWLEGS AND KNOCK-KNEES IN CHILDREN

Bowlegs and knock-knees are two conditions in which the legs are not as straight as they are in most persons. In bowlegs, the legs bend outward so that the knees are farther apart than usual. In knock-knees, the legs bend inward so that the knees are closer together.

Theoretically, when a child stands straight, the ankle bones should touch or almost touch each other, and the knee bones should touch or almost touch each other. With an infant lying on the stomach or back, the legs can be pulled straight with the toes and knees pointed straight ahead to determine whether the bones of the knees and ankles come together. If ankles touch but the knees do not, the child can be said to be bowlegged. If the knees touch but the ankles do not, the child is knock-kneed.

By these standards, however, all infants, children, and adults are bowlegged or knock-kneed to some degree, so you should not become alarmed. Most infants appear bowlegged until they walk. Then when they start to walk, they walk “cowboy” style. This condition usually corrects itself by age two. Most preschoolers stand knock-kneed, especially if they are plump. This condition also corrects itself.

True bowlegs and knock-knees either are due to rickets (vitamin D deficiency) or are inherited. Once common 50 and more years ago, rickets is now rare. An unusual form of bowlegs, often occurring only on one side, is Blount’s disease, in which the top of the tibia (shin bone) becomes deformed.

Signs and symptoms

Have the child stand with the legs straight and the toes pointed forward. Then observe if there is any distance between the knees or ankles. Remember that any distance between the ankles or the knees varies from person to person and that these differences are usually normal. If you think that there might be a problem, ask your doctor.

Home care

In most cases, no home care is needed. To prevent rickets, all children should receive about 400 international units of vitamin D daily. This amount is found in many commercial infant formulas and in most commercial milk. Some vitamin D is present in breast milk, but the amount varies. If your child is being breast-fed, ask your doctor whether the child is receiving enough vitamin D.

Precautions

• If you think your infant or child is bow-legged or knock-kneed, watch to see if, after several months, the condition worsens. If it does, consult your doctor.

• Do not use orthopedic shoes without your doctor’s prescription.

• Do not give your child vitamin D supplements unless your doctor has prescribed them. Overdoses of vitamin D can be harmful.

Medical treatment

In most instances, your doctor will examine your child and then prescribe no treatment—except to wait and watch. X rays of the knees may be required as well as blood tests for rickets. Use of orthopedic shoes or night splints is rarely necessary. For Blount’s disease, braces or corrective operations on bones may be required.

*26/84/5*

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This entry was posted on Tuesday, April 28th, 2009 at 9:24 am and is filed under General Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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