$Unique_ID{PAR00029}
$Pretitle{}
$Title{Medical Advice:  Bowlegs and Knock-knees}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Bowleg Bowlegged Bowlegs Knock-knees rickets vitamin D deficiency
deficiencies Blount's disease}
$Log{}

Your Child:  A Medical Guide


Bowlegs and Knock-knees


Quick Reference

     SYMPTOMS
     - Legs bent outward at knees (bowlegs)
     - Legs bent inward at knees (knock-knees)

     HOME CARE
     - Usually no home care is needed.
     - If you think your child has bowlegs or knock-knees, consult your
       doctor.

     PRECAUTIONS
     - Do not use orthopedic shoes unless prescribed by your doctor.
     - To prevent rickets (a deficiency of vitamin D, which may cause bowlegs
       and knock-knees), all children should receive recommended amounts of
       vitamin D.  (Milk is a good source of vitamin D.)
     - Do not give your child supplements of vitamin D unless your doctor has
       prescribed them.  Overdoses of vitamin D are harmful.


     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 than normal.
     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 the 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, and 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.  Although common 50 years ago, rickets is now
rare in the United States.  An unusual form of bowlegs, often occurring on
only 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 between the ankles.
Remember that the 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, 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 bowlegged or knock-kneed, watch to
     see if the condition worsens after several months.  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, the doctor will examine your child and then prescribe
no treatment--except to wait and watch.  X-ray studies of the knees may be
necessary, 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.