|
https://upload.orthobullets.com/topic/4057/images/Clinical photo - courtesy Miller_moved.png
https://upload.orthobullets.com/topic/4057/images/cvf vs. postero medial bowing.jpg
https://upload.orthobullets.com/topic/4057/images/Xray - AP - lat leg - courtesy Miller_moved.png
https://upload.orthobullets.com/topic/4057/images/posteriomedial tibial bowing xray.jpg
Introduction
  • Physiologic bowing of tibia thought to be a result of intrauterine positioning
    • usually involves middle and distal third of tibia
  • 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
  • Prognosis
    • most common sequelae of posteromedial bowing is average leg-length discrepancy of 3-4 cm  
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
Complications
  • Leg length discrepancy
    • patient may have residual 2-5 cm leg length discrepancy at maturity 
    • may require age-appropriate epiphysiodesis of long limb
 

Please rate topic.

Average 4.1 of 26 Ratings

Questions (7)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK

(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? Review Topic

QID: 684
FIGURES:
1

metatarsus primus varus

2%

(31/1341)

2

equinovarus

12%

(158/1341)

3

cavovarus

8%

(104/1341)

4

metatarsus adductus

11%

(151/1341)

5

calcaneovalgus

66%

(887/1341)

Select Answer to see Preferred Response

PREFERRED RESPONSE 5

(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? Review Topic

QID: 397
FIGURES:
1

knee instability

6%

(80/1403)

2

residual limb-length discrepancy

64%

(898/1403)

3

pseudoarthrosis

16%

(224/1403)

4

scoliosis

7%

(98/1403)

5

tarsal coalition

7%

(99/1403)

Select Answer to see Preferred Response

PREFERRED RESPONSE 2
ARTICLES (6)
GROUPS (1)
Topic COMMENTS (8)
Private Note