Common Childhood Orthopedic Conditions

In-Toeing (Pigeon Toes)

In-toeing (medical name: femoral anteversion), or walking pigeon-toed (with feet turned inward), is another normal variation in the way the legs and feet line up. Babies may have a natural turning in of the legs at about 8 to 15 months of age, when they begin standing.

Treatment for pigeon-toed feet is almost never required. Special shoes and braces commonly used in the past were never proved to speed up the natural slow improvement of this condition. In-toeing typically doesn't interfere with walking, running, or sports, and resolves on its own as kids grow into teens and develop better muscle control and coordination.

Bowlegs

Bowleggedness (medical name: genu varum) is an exaggerated bending outward of the legs from the knees down that can be inherited. It's common in infants and, in many cases, corrects itself as a child grows.

Bowleggedness beyond the age of 2 or bowleggedness that only occurs in one leg but not the other can be the sign of a larger problem, such as rickets or Blount's disease. Rickets, a bone growth problem usually caused by lack of vitamin D or calcium in the diet, causes severe bowing of the legs and can also cause muscle pain and enlargement of the spleen and liver. Rickets is much less common today than in the past. Rickets and the resulting bowlegs are almost always corrected by adding vitamin D and calcium to the diet. Some types of rickets, however, are due to a genetic condition and may require more specialized treatment by an endocrinologist.

Blount's disease is a condition that affects the tibia bone in the lower leg. Leg bowing from Blount's disease is seen when a child is about 2 years old, and can appear suddenly and quickly become worse. The cause of Blount's disease is unknown, but it causes abnormal growth at the top of the tibia bone by the knee joint. To correct the problem, kids may need bracing or surgery when they're between 3 and 4 years old.

You should also take your child to the doctor if bowleggedness occurs only on one side or gets progressively worse.

Knock-Knees

Most kids show a moderate tendency toward knock-knees (medical name: genu valgum) between the ages of 3 and 6, as the body goes through a natural alignment shift. Treatment is almost never required as the legs typically straighten out on their own. Severe knock-knees or knock-knees that are more pronounced on one side sometimes require treatment.

Reviewed by: Alfred Atanda Jr., MD
Date reviewed: November 2011