Types of bow legs

A developmental pattern in a young child differs from bowing caused by altered bone growth, a metabolic bone problem, previous injury or joint wear in adulthood. Labels describe a pattern; examination determines what that pattern means for the individual.

Developmental bowing is generally considered in the context of a child's growth and is often similar on both sides. Pathological bowing means an underlying disorder or abnormal growth process may be shaping the leg. Post-traumatic bowing can follow a fracture or growth-plate injury, while degenerative varus may develop when wear is greater on one side of the knee.

The curve may arise mainly in the thighbone, the shinbone, around the knee, or from a combination of levels. It may be symmetrical, unequal, or confined to one limb. Rotation of the leg and foot can make the visible curve appear stronger and can alter the walking pattern.

Have the legs assessed while standing and walking rather than relying only on a seated photograph. A clinician checks hip and knee motion, kneecap direction, foot progression, limb length and where the curve is centred. Standing imaging may be requested when precise bone and joint alignment would change management.

Record whether the appearance has progressed and mention fractures, childhood bone problems, nutrition concerns and family patterns. These details help separate a normal growth variant from a form needing targeted care.

Seek assessment when bowing becomes more noticeable, differs markedly between sides, appears with pain or swelling, or interferes with walking and play. A new change after trauma, repeated giving way, or a persistent limp deserves prompt attention.

Immediate evaluation is appropriate if an injured leg cannot take weight, has an obvious new deformity, or the foot becomes numb, unusually pale or cold.

Ask what type of bowing is present, where the deformity is centred, whether rotation contributes to its appearance and whether it is likely to change. Request a clear explanation of which finding supports observation, physiotherapy, bracing or a surgical opinion.