Understanding Adolescent Idiopathic Genu Valgus: A Guide to Managing Knock Knees by Distal femur Closed Wedge Corrective Osteotomy
Abstract:
Genu valgum, also known as “knocked knees,” is a coronal plane
misalignment of knee characterized by inward bending of the knees. When
individuals with genu valgum stand with their knees together, there is a
noticeable gap of 3 inches or more between their ankles due to the pronounced
inward curvature of the knees. This coronal plane deformity of knee joint is
one of the commonest disorders presenting to orthopaedic clinic in adult
patients with rheumatoid arthritis, however its prevalence in adolescent is
rare. Paediatric age group presenting with bilateral genu valgum can be either
physiologic or pathologic. While the physiological genu valgum typically starts
around age 2 and becomes most prominent between ages 3 to 4, gradually
stabilizing by age 7, pathological genu varum persists more than 10 years of
age. In adolescents, minimal change back to normal alignment is expected.
Pathologic genu valgum, on the other hand, may be associated with metabolic
disorders (e.g., Rickets), local issues (infection, tumour growth, or trauma),
idiopathic or other factors. Treatment options vary based on the cause and
severity. Conservative approaches include exercise programs, NSAIDs, and
orthotic insertions. Surgical interventions, such as osteotomy or guided growth
surgery, may be necessary in severe cases. We here report a
rare case of idiopathic bilateral genu valgus deformity presented with progressive valgus deformity of both knees.
Since the misalignment was more on the femoral side, corrective osteotomy was
done in the distal femur to achieve proper mechanical alignment of the knee. This
case report seeks to provide healthcare workers about this condition
and the differential diagnosis and a detailed management.
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