I have fond memories of playing in my yard as a child. Being an only child with fruit trees and yard space, it became tradition for the other neighbourhood kids to come to my house. We climbed, rode my bike, and just did the fun things kids would do before the internet and cable existed. There was one particular neighbour, David, who had ‘serious bandy legs’; as I decided on this topic, he came to mind. As you read on, you would understand my wonder as to what, if any treatment/surgery was done to what we trinis would call David’s ‘wicked bandy’. I further wondered, where in the world is David now…
Women are known to have bandy/bow legs also, but for some reason, it is seen more in men. Often you would hear someone say “whey, you ain’t see that wicked bandy that fella have, he looking sexy too bad with it!” I myself have been guilty of going off on a ‘sweet bandy’, especially on tall men. Like with everything, there is a reason such occurs, and again like with everything else, there are variations in the way it is. Some people have only one bowed leg, while another combination is those that are bowed so much that they look like an ‘O’ that is formed. It most commonly starts with toddlers.
It isn’t unusual for toddlers to be slightly bow legged. In some instances, toddlers have bowed legs that may even interfere with the initial walking process. The majority of cases of bowed legs in toddlers result from physiologic genu varum; the medical term that refers to a variation in normal appearance which makes them appear bow-legged. Most toddlers have bow legs from positioning in the uterus; and this curvature remains until the muscles of the lower back and legs are strong enough to support them in the upright position.
In other cases, abnormal growth of the bone causes the bowing to get worse over time, instead of better. This condition is called Blount’s disease or pathologic tibia varum.
It not only results in abnormal growth of the upper portion of the tibia, or shin bone, but in about 60% of cases, both legs are affected. The disease becomes obvious between the ages of two and four, and overweight adolescents or teenagers can also develop it.
Another common disease that causes bowing is rickets. It is a metabolic disorder caused by a deficiency of vitamin D. This deficiency disorder tends to occur most in under-developed countries.
Treatment depends on the age of the child and the stage of the disease. Between birth and age two, careful observation is done or a trial of bracing. If the child doesn’t receive treatment, Blount’s disease will gradually get worse with more and more bowlegged deformity. Surgery may be needed to correct the problem. For the obese child, weight loss is helpful but often difficult.
• Bow legs or genu varum usually begins to improve around the age of 15 to 18 months. By age three, generally, the problem would resolve without any type of bracing or treatment.
• In the case of Blount’s disease, aggressive treatment is needed. Severe bowing before the age of three is braced. As the bone straightens out with bracing, it is changed regularly to correct the bowlegged position.
• Surgical correction may be needed especially for the younger child with advanced stages of tibia varum, or the older child. Surgery isn’t usually done on children under the age of two because at this young age, it’s still difficult to tell if the child has Blount’s or just excessive tibial bowing. A tibial osteotomy is done before permanent damage occurs. Brace treatment for adolescent Blount’s is not effective, and requires surgery to correct the problem.
• In some patients with adolescent Blount’s disease, the bowed leg is shorter than the normal or unaffected side. Surgery to correct the angle of the deformity isn’t always possible. In such cases an external fixation device is used to provide traction to lengthen the leg while gradually correcting the deformity. This operation is called a distraction osteogenesis. The frame gives the patient stability and allows for weight bearing right away.
The reason you see many adults with bandy legs is because their parents never checked out or couldn’t afford to address the issue. In other instances the primary care physician may have stated that it wasn’t a bad case and that there wasn’t a need to have anything done. My advice is to have at least one consultation at the toddler stage to ensure that all is progressing well.
Your feet mirror your general health . . . cherish them!