Bone, growth & fractures

Knock Knees, Bow Legs & Limb Length

Correcting angular deformity and limb-length difference while a child is still growing.

Knock knees (genu valgum) and bow legs (genu varum) are part of normal development in many young children and correct on their own. In some they do not — or a difference in leg length develops — and in a growing child that is something that can be worked with rather than around.

A toddler standing outdoors, seen from the knees down

Using the growth that is left

While a child is still growing, the growth plates themselves can be used to correct alignment gradually. This is the principle behind guided growth, which Dr. Green lists among his areas of practice.

Because the technique depends on growth remaining, timing matters: the assessment is about how much growth is left, not only about the current angle.

How Dr. Green decides between surgery and non-surgical treatment

How Dr. Green treats knock knees, bow legs and limb-length difference

Guided growthUsing the child’s remaining growth to correct angular deformity gradually.
Limb-length assessmentEvaluating a difference in leg length and how it is likely to change with growth.

9 peer-reviewed papers on deformity and growth

Dr. Green's published research on guided growth

Of the papers indexed on PubMed under Dr. Green’s Hospital for Special Surgery affiliation, 9 are on this subject.

See the full publication record

Dr. Green wrote HSS’s clinical article on this condition

Complex Case: Anterior Knee Pain with Genu Valgum appears in the HSS health library with Emilie Lijesen, BS and Shae K. Simpson, BS. He is the first of 3 authors. The article is HSS’s, and it is published there rather than reproduced here.

Read it on hss.edu

The papers themselves

The 8 most recent of his 9 papers on this subject, indexed on PubMed under his Hospital for Special Surgery affiliation. Each opens on PubMed.

All 9 of his papers on this subject

Patients Dr. Green has treated for this condition

The Hospital for Special Surgery publishes these accounts in its Back in the Game archive. All 2 list Dr. Green as the treating surgeon. Each has its own page here, cited back to hss.edu.