- Idiopathic genu varum (spontaneous origin, inherited characteristic of skeleton development).
- Knee osteoarthritis which disrupts joint stability and causes deformity in advanced stages.
- Posttraumatic deformities due to malunion of previous femur or tibia fractures.
- Bone growth disorders, such as Blount's disease (tibia vara).
- Rickets and related metabolic bone diseases.
- Asymmetrical development leading to leg length discrepancy.
The team of orthopedists at Medical Time Hospital offers precise diagnostics and solutions ensuring the symmetry and health of your joints.
Bow legs, clinically known as varus knee deformity or genu varum, are the most common reason for surgical leg shape correction. The main manifestation of this deformity is a visible distance between the knees in a standing position with feet together, leading to a deviation of the mechanical axis. Wrong load distribution causes premature wear of knee joints. Thus, the aim of modern correction is not only an aesthetic result but primarily preventing knee osteoarthritis in mature adulthood. The surgical approach, which often involves the Ilizarov apparatus and osteotomy, allows for the restoration of the normal biomechanics of the lower extremities.
Main causes of genu varum deformity
How to define your leg shape?
You can easily define your leg shape yourself according to the standard classification and consider if professional consultation is needed.
Ideal legs: Knees, calves, and ankles are touching, creating three natural intervals between them.
True O-shaped (genu varum): Knees cannot be attached to each other when ankles are touching. The main reason is varus deformity of the tibia below the knee.
False curvature: Bones are straight, but the unique structure of soft tissues on the shin creates the visual effect of crooked legs.
True X-shaped (genu valgum): Knees are touching, but ankles are separate, mostly due to femur deformity.
Important note for patients: Genu varum is more prevalent in Asian regions but occurs worldwide. An X-ray clearly shows the deviation of the weight-bearing line.
Principles of leg shape correction (Ilizarov)
The common principle of correction includes osteotomy of the tibia in the deformed area and fusion in the correct position using the Ilizarov apparatus.
An extensive surgical approach is not necessary for the osteotomy. A small stab incision of 5 to 10 mm is usually appropriate.
If shin soft tissues are aesthetically favorable, an excellent result can be achieved with an incomplete osteotomy, fissuring the bone from one side.
After performing the osteotomy, the axis of the extremity is adjusted for its correct layout and fixed in that position for further bone union.
The Ilizarov apparatus is a perfect device for correction and fixation. It weighs only 900 grams and can be easily covered with trousers.
Treatment time and postoperative recovery
The average time from surgery up to the moment of removing the device is about 3 months. If leg lengthening is performed, about 1 month is added for each centimeter.
This term implies a gradual increase in loads and activity during the process of fixation.
Immediately after the removal of the devices, patients have the ability to fully load the legs and walk freely without restrictions.
The time of wearing the apparatus can be reduced by gradual and strictly controlled loading on the legs under medical supervision (by 5 to 10%), or by using an incomplete osteotomy.
Advantages of Ilizarov technique
- Precise correction of malalignment
- Ability to perform medialisation of bone fragments
- Efficient elimination of rotational displacement
- Addressing the protruding head of the fibula
- Possibility of simultaneous limb lengthening
- Early mobilization and a minimally invasive surgical approach
Frequently asked questions about bow legs correction
Idiopathic genu varum (bow legs) is a deformity of spontaneous origin that represents a congenital individual characteristic of skeleton development, which is inherited. Shape variations are related to age, sex, and ethnicity.
Wrong load distribution due to varus deformity causes premature wear of the knee joint. Bow legs correction (high tibial osteotomy) delays or prevents early degenerative changes by restoring more favorable biomechanics.
Blount's disease (tibia vara) is a growth disorder of the tibia that results in lower limb inward angulation, resembling a bowleg. The deformity requires early correction to prevent further joint deterioration.
No, the Ilizarov apparatus used today is lightweight and weighs only about 900 grams. It can be covered with trousers without any problems, and patients are advised to gradually move during recovery.
The average time of wearing the device is 3 months for axis correction. If leg lengthening is also required, the therapy is extended by about 1 month for each centimeter of lengthening.
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