What are Bowlegs or Bandy Legs?
Bowlegs is a condition where upon standing, the knees stay wide apart and the ankles are together with the legs bowed-out, thus giving the appearance of a bow to the legs and hence the name. Bowlegs is medically known as “Genu varum” and is also known as tibia vara, bandiness, bow-leggedness and bandy-leg. Bow-leggedness is a varus deformity where the lower leg is angled inwardly and is not in line with the axis of the thigh, which gives the legs an appearance of archer’s bow. Usually there is inward angulation of both the lower limb bones. Bowlegs can occur due to genetic problems, poor nutrition, mineral and vitamin deficiencies.
Bowlegs or Bandy Legs can also be an indication of an underlying disease, such as rickets or Blount’s disease; and if not treated on time, can lead to arthritis of the hips and knees. Treatment for Bow Legged or Bandy Legs includes casts, braces or surgery to correct the bone abnormalities.
Bowlegs or Bandy Legs is commonly seen in infants as they have to stay put in a cramped position in the mother’s womb for nine months. Treatment is not usually needed in such cases, as this type of Bow Leggedness in infants is normal and the legs will eventually straighten when the child starts to walk with no lasting side effects most of the times. If the bow leggedness or bandy legs persists beyond the age of 2 years, then medical treatment should be sought for it. If the bowlegs persist and remain in older children, then treatment such as braces and cast is needed. Surgery is usually required for persistent bowlegs or bandy legs in older adolescents and adults
What are the Causes of Bow Leggedness or Bandy Legs?
Rickets is a medical condition which occurs as a result of chronic vitamin D deficiency, which leads to softening and weakening of the bones and causes the legs to bow.
Blount’s disease (tibia vara) is a medical condition where there is abnormal development of the child’s shin and it curves below the knees. When the child begins to walk, there is worsening of the Bow Leggedness or bandy legs. Many times, this condition is obvious in the child’s early years; however, sometimes may not be noticeable until the child has reached adolescence. As time passes, the bowlegs cause knee joint problems. Blount’s disease commonly affects African-Americans, females and obese children. Children who start to walk early are at an increased risk of getting bowlegs or bandy legs.
This is a metabolic condition which has a negative effect on the patient’s bones where the bones break down and do not get rebuilt as strongly as they are supposed to. This over a period of time leads to bowlegs or bandy legs and other problems with the joints. Older people are more commonly affected with Paget’s disease. This condition can be managed successfully with early diagnosis and treatment.
Other Causes of Bowlegs or Bandy Legs
- Bone dysplasia or abnormally-developed bones.
- Bone fractures, which have not healed properly.
- Fluoride poisoning.
- Lead poisoning.
What are the Symptoms of BowLegs or Bandy Legs?
Bow Leggedness is an easily identifiable condition. The patient’s knees will not touch each other upon standing with the feet and ankles remaining together. There is symmetry to Bowlegs. In children who have Bow Leggedness, their bowlegs improve after they start walking. If the Bow Leggedness persists beyond the age of 2 years or if the Bow Leggedness worsens, then medical attention should be sought.
How is Bow Legged or Bandy Legs Diagnosed?
It is easy to spot Bow Legs or Bandy Legs, however, only a doctor can tell regarding the severity of the Bow Leggedness and if it is caused by an underlying disease.
The doctor takes measurements of the patient’s legs and observes the patient’s walk. X-ray and other imaging tests of the legs are also done to check for any abnormalities in the bones. Blood tests are done to confirm if the cause of bowlegs is other conditions, such as Paget’s disease or rickets.
How is BowLegs or Bandy Legs Treated?
Treatment is not needed in infants and toddlers who have Bow Leggedness unless there is an underlying condition identified as the cause of BowLegs or Bandy Legs.
Treatment is done if the severity of Bow Leggedness is extreme or if there is worsening of the bowlegs or if there is an underlying medical condition causing the bow legs or bandy legs.
Treatment for Bow Legs or Bandy Legs includes: Use of special shoes, casts, braces and surgery to correct any bone abnormalities, which are causing Bow Leggedness. Treatment for any diseases or medical conditions which are causing bowlegs or bandy legs is done accordingly.
Can Bowlegs or Bandy Legs Be Prevented?
Bowlegs or bandy legs cannot be prevented; however, in certain cases, conditions which can cause bowlegs can be prevented, such as, rickets can be prevented by making sure that the child receives sufficient vitamin D through sunlight as well as diet. It is important to diagnose bowlegs or bandy legs as early as possible so that treatment and management of this condition can be started appropriately.
What is the Prognosis of Bowlegs or Bandy Legs?
The prognosis of Bowlegs or Bandy Legs is usually good and the child has no problem in walking after the treatment is done.
What are Complications of Bowlegs or Bandy Legs?
Persistent Bow Leggedness which is not treated causes complications like arthritis in the knees or hips eventually which can be very disabling for the patient. Severe arthritis affects the knees, ankles, feet and hip joints due to the abnormal stress on the joints. Obesity is another factor which is commonly seen in such patients and which compounds this problem of arthritis. If the patient needs total knee replacement at a young age, then probably a revision would need to be done when the patient is older.
Surgery for BowLegs or Bandy Legs
Bowleg correction surgery is done in healthy adolescents who are about 16 years and older; and healthy adults who are up to the age of 55. It is advisable to postpone surgery for correcting Bowlegs or Bandy Legs in younger adolescents as they are still growing and surgery at this age can lead to future complications. Bowleg correction surgery is done by an orthopedic surgeon who specializes in this type of procedure.
A small incision is made by the orthopedic surgeon through the skin along with a partial cut in the bone. The orthopedic surgeon straightens the bow leg after which an internal rod or an external device known as external fixator is placed. The external fixator acts as a scaffold outside the leg and helps in straightening and supporting the leg through the healing period.
How Long Does it Take to Recover after Bowlegs or Bandy Legs Correction Surgery?
The time taken for Bowleg correction surgery is about an hour and many patients spend the night in the hospital and are discharged the next morning. It is not necessary to place a cast and patients are encouraged to put weight on the leg and start walking almost immediately. Many patients are able to walk without the help of crutches with little or no pain. There are some patients with bowlegs or bandy legs who experience pain which usually abates after the Bowleg correction surgery. Additional bonus of Bowleg or bandy legs correction surgery is that there is an increase of about half- an-inch in height of the patients after the Bowleg correction surgery as the bowed bones are now straight giving a boost to the patient’s height. Complete healing after Bowleg correction surgery is about two months. However, the frames can be removed before that time if the x-rays reveal that the bone is sufficiently healed and is solid.
Exercises After Bow Leg Correction Surgery
Patients are encouraged to start physical activity and participate in physical therapy and mild exercises under supervision during the healing process after the bow leg correction surgery. Patients who are active and participate in the rehab will experience faster healing and better results after Bow Leg Correction Surgery. Some of the good exercise options after bow leg correction surgery include walking and swimming. Patients who are active in physical therapy have faster healing, better muscle strengthening and good flexibility. The scarring after the bow leg correction surgery is minimal, as the incisions made are small and usually fade with time. As the previously bowlegs gradually straighten, the muscles also strengthen and any pain remaining in the knees and hips also resolves.
- National Institutes of Health (NIH): “Paget’s Disease of Bone”: https://www.niams.nih.gov/health-topics/pagets-disease-bone