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Bowlegs (Congenital Genu Varum)

Bowlegs is a condition in which your legs appear bowed-out, meaning your knees stay wide apart even when your ankles are together. Bowlegs can sometimes be a sign of an underlying disease, such as Blount’s disease or rickets, and in the long term can lead to arthritis in the knees and hips. Treatment options include braces, casts, or surgery to correct these bone abnormalities.

This condition is fairly common in infants because of their cramped position in the womb. Typically, no treatment is necessary for infants. A child’s legs will begin to straighten when they start to walk, usually between 12-18 months, and in most cases there are no lasting side effects. You should contact a doctor if your child has bowlegs beyond the age of 2.

Bowleggedness is also known as congenital genu varum.

Causes of Bowlegs

Blount’s Disease

In Blount’s disease, which is also called "tibia vara," a child’s shin abnormally develops, curving below the knees. As your child starts to walk, the bowing of the legs becomes worse. This condition may be apparent early on but in some cases symptoms may not be noticeable until they reach adolescence. Over time, bowlegs can lead to joint problems in their knees.

Blount’s disease is more common in females and African-Americans, and obese children. Children who begin walking early are at a greater risk. A child should normally start walking on their own between 11 and 14 months of age.


Rickets is a condition resulting from prolonged vitamin D deficiency. This softens and weakens the bones, causing your legs to bow.

Paget’s Disease

This metabolic disease negatively affects the way your bones break down and rebuild. As a result, they do not rebuild as strongly as they should, and over time this can lead to bowlegs and other joint problems. Paget’s disease is more common in older people and can be successfully managed with early diagnosis and treatment.


The most common form of dwarfism is caused by a condition known as achondroplasia. This is a bone growth disorder that can result in bowlegs over time.

Other Causes

Bowlegs can also be a result of:

  • bone fractures that have not healed properly
  • abnormally-developed bones, or bone dysplasia
  • lead poisoning
  • fluoride poisoning

Recognizing the Symptoms of Bowlegs

This is a very recognizable condition. Your knees will not touch when you stand with your feet and ankles together. Bowlegs will look symmetrical.

In children, most bowleg cases start to improve when a child reaches 12-18 months old. You should talk to your pediatrician if your child’s legs are still bowed beyond the age of two, or if the condition becomes worse.

Diagnosing Bowlegs

Bowed legs are easy to spot, but your doctor can tell you how severe the condition is or whether it is caused by an underlying disease.

During your visit, your doctor will likely take your leg measurements and observe your walk. They may also order an X-ray or other imaging tests of your legs and knees to view any bone abnormalities, and blood tests to confirm your bowlegs are caused by another condition such as rickets or Paget’s disease.

Treatment of Bowlegs

Treatment is usually not recommended for infants and toddlers unless an underlying condition has been identified. Treatment may be recommended if your case of bowlegs is extreme or getting worse, or if an accompanying condition is diagnosed. Treatment options include:

  • special shoes
  • braces
  • casts
  • surgery to correct bone abnormalities
  • treatment of diseases or conditions that cause bowlegs

Can Bowlegs Be Prevented?

There is no known prevention for bowlegs. In some cases, you may be able to prevent certain conditions that cause bowlegs, for example, you can prevent rickets by making sure your child receives sufficient vitamin D, both in their diet and from exposure to sunshine. Be sure to talk to your pediatrician if your child still has bowlegs after the age of two.

Early diagnosis and detection of bowlegs will help you and your child manage this condition.

While arthritis is the primary long term effect of bowleggedness, it can be extremely disabling.  When it is severe,  it effect the knees, the feet, ankles and the hip joints because of the abnormal stresses applied.  These people are typically obese which compounds the problem.  If one is forced to do total knee replacement at a young age, then it is anticipated that a revision would have to be done when the patient is older.  Doing a total knee arthroplasty in these people may be difficult because of the surgeries they have already undergone and because of the abnormal alignment of the bones.

Content licensed from:

Written by: Ann Pietrangelo
Medically reviewed on: Feb 23, 2016: William A Morrison, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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