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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Knock Knees

Genu valgum, more commonly known as knock knees, is a condition in which the knees angle in and touch one another when the legs are straightened. Genu is the Latin word for knee and 'valgus' means in-curving. Mild genu valgum may be seen in children, typically between the ages of 2 and 6. When a child has knock knees, both knees usually lean inwards to an equal degree. However, one knee may 'knock' less than the other or remain completely straight. In most cases, this problem corrects itself naturally as children grow. However, if the problem worsens and persists with increasing age, it may be due to an underlying disease, such as rickets or obesity. Severe genu valgum requires treatment, in order to prevent children from developing structural problems in the upper leg bones (Children's Hospital Boston, 2005-2010; Leary, 1990; Wikipedia, 2011).

Symptoms:

  • A small amount of 'knocking of the knees is normal but the following signs may be indicative of a problem;
  • A significant difference between the angle of the one leg and the other when standing straight.
  • An excessive inward or outward knee angle.
  • Your child is experiencing pain due to the angle of their knee/s.
  • Walking difficulties or limping
  • Knock knees at an angle of greater than 15 degrees (NHS Direct Wales; UCSF Benioff Children's Hospital, 2010).

Causes:

Knock knees often develop during childhood, as a part of natural growth. When children begin to walk, their knees may knock together, in an effort to maintain balance. This may also occur if the child's foot rolls inwards or turns outwards.

Rickets- a deficiency of vitamin D. Rickets results in bone development being softer than normal, causing the legs to start to bow.

Scurvy- a deficiency of vitamin C, that affects bone and joint development.

Obesity- Children who are overweight are most likely to develop knock knees, because their developing bones and joints have trouble supporting their weight and they have a tendency to lean inwards.

Injury to the growth area of the tibia (shinbone), may impair bone growth and cause knock knees. This type of injury generally only occurs in 1 leg, therefore only causing one knocked knee.

Weak ankles as a result of flat feet (Children's Hospital Boston, 2005-2010; Ladisten, 2007-2008).

Diagnosis:

Knock knees are evident, when a child stands with their legs straight and their feet pointing forwards. The severity of the condition can be established by; observing the position of the child's legs, knees and ankles, and by measuring the distance between the inner ankle bones. The further the distance between the ankles, the more severe the condition is. In children between the ages of 2 and 4, a distance of 6cm is regarded as normal. In older children, the ankles can be as far as 10cm apart without there being any cause for concern.Your doctor will also require a full medical history and may take x-rays to determine the extent of the bone deformity (Children's Hospital Boston, 2005-2010; NHS Direct Wales).

Treatment:

Mild cases of genu valgum, generally do not require treatment and resolve on their own. In more severe cases, your doctor may prescribe a night brace, especially if there is a family history of knock knees. A night brace is attached to a shoe and functions by pulling the knee into a straight position. Orthopaedic shoes, with a heel wedge and possibly a arch pad, may be recommended. The problem can also be helped with physical therapy. If these treatment options fail, corrective surgery (osteotomy) may be performed, to straighten the legs. This provides a cosmetic remedy to the problem and may therefore help self-esteem issues surrounding genu valgum, as well as alleviating walking difficulties, and will help to prevent or postpone knee replacement later in life (Children's hospital Boston, 2005-2010; Ladisten, 2007-2008; MedicineNet.com; Wikipedia, 2011).

Prognosis:

Children normally outgrow knock knees without requiring any treatment, unless there is an underlying medical condition. In rare cases, that warrant surgery, the procedure has very effective cosmetic results (A.D.A.M, 2011).

Uncorrected severe genu valgum may result in the following problems later in life;

  • Poor posture may affect the hip joints, back or feet, resulting in a limp or problems walking.
  • Early osteoarthritis of the knee.

Knee pain and progressive deformation.

Changes in self-esteem, related to the cosmetic appearance of the knock knees.

The need for knee replacement surgery (Ladisten, 2007-2008).