Summary Posteromedial Tibial Bowing is a congenital condition thought to be a result of intrauterine positioning that typically presents with a calcaneovalgus foot deformity and leg length discrepancy. Diagnosis is made radiographically with xrays of the tibia. Treatment is observation for bowing deformity which usually spontaneously corrects over 5-7 years. If leg-length discrepancy develops, nonoperative or operative management may be indicated depending on the severity of the discrepancy. Epidemiology Anatomic location usually involves middle and distal third of tibia Etiology Genetics no known genetic association Associated conditions calcaneovalgus foot posteromedial bowing is often confused with calcaneovalgus foot, another condition caused by intrauterine positioning the two conditions may occur together or independently of each other Presentation Symptoms presents at birth Physical exam posteromedial bowing apex of deformity is in the distal tibia calcaneovalgus foot deformity apex of deformity is at the ankle Imaging Radiographs recommended views AP and lateral of tibia findings will see posterior medial bowing Treatment Nonoperative observation indications observation is indicated for bowing deformity which usually spontaneously corrects over 5-7 years make sure to follow clinically to monitor for leg length discrepancy associated calcaneovalgus foot treated with observation and parental stretching Operative age-appropriate epiphysiodesis of long limb indications projected leg length discrepancy > 50% of patients end up requiring surgical intervention for LLD Complications Leg length discrepancy patient may have residual 2-5 cm leg length discrepancy at maturity may require age-appropriate epiphysiodesis of long limb Prognosis Sequelae Most common sequelae of posteromedial bowing is average leg-length discrepancy of 3-4 cm
QUESTIONS 1 of 8 1 2 3 4 5 6 7 8 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ08.11) An infant is born with a unilateral lower extremity deformity. A clinical photo is shown in figure A. Radiographs are shown in figure B. Which of the following conditions are associated with this type of deformity? QID: 397 FIGURES: A B C Type & Select Correct Answer 1 knee instability 5% (98/1851) 2 residual limb-length discrepancy 63% (1167/1851) 3 pseudoarthrosis 16% (297/1851) 4 scoliosis 8% (139/1851) 5 tarsal coalition 8% (144/1851) L 3 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept (OBQ07.23) A 3-month-old child presents with the tibial deformity seen in Figure A. What foot deformity is commonly associated with this condition? QID: 684 FIGURES: A Type & Select Correct Answer 1 metatarsus primus varus 2% (39/2006) 2 equinovarus 12% (232/2006) 3 cavovarus 9% (172/2006) 4 metatarsus adductus 11% (223/2006) 5 calcaneovalgus 66% (1325/2006) L 2 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept
All Videos (0) Podcasts (1) Pediatrics⎪Posteromedial Tibial Bowing Orthobullets Team Pediatrics - Posteromedial Tibial Bowing Listen Now 12:59 min 4/1/2020 136 plays 4.0 (1)