Legs in Children Curvature and Shortness
The goal in treating leg deformities and discrepancies in children is to achieve a perfectly normal leg that gives the appearance that there had never been any illness. Leg deformities can be congenital or occur naturally during growth. Sometimes a deformity or discrepancy can occur following a fracture treatment due to incorrect fusing of the bone or growth plate injuries.
In children, unlike adults, bone deformities can improve during growth, and on the other hand they can also increase during growth. In situations that affect the growth plate (congenital or those arising from trauma), the degree of the discrepancy increases with age due to the differences in the growth rate between the two legs. In children, premature lengthening surgeries can fail and result in discrepancies occuring at an older age. However, in some cases, lengthening or correction surgeries done late can lead to permanent damage to joints as well as the spine. After growth is complete (ages 14-16 for males; ages 12-14 in females), the discrepancy or deformity in the leg does not change, so there is no progression. Because of these reasons, it is very important to establish the correct time for an operation as well as choose the correct treatment for children, as opposed to adults.
During growth, physiological deformities in the leg are normal and do not require treatment. In the first 3 years there is the physiological "bowleg" that can be seen in the legs. The condition reduces over time during the child's growth after 15-18 months and completely clears up between 3-4 years old. However, in some cases (such as Blount's disease, fibromyalgia, vitamin-D deficiency, achondroplasia) growth is not enough to make an improvement. It is absolutely necessary to monitor the child and make a separate diagnosis. In the normal development process, the maximum varus (bowleg) occurs in the legs at age 1, at age 2 there is a more natural alignment (even), and at age 4 the maximum valgus (knock knees) can occur. By age 11, the legs have reached the shape they will retain into adulthood. In addition, in some cases valgus deformity (L-shaped deforrmity) may develop after a tibia fracture, which is referred to as the "Cozen's Phenomenon" and does not require treatment; it will correct itself spontaneously within 1 year at the most.