Therapy of bow legs
Causes of bow legs
Usually misalignments of the leg axes are congenital and already appear in children and adolescents. If left untreated, this misalignment of the leg axis is all the more likely to lead to generalized arthrosisthe earlier it occurs.
It is also possible for bow legs to develop through tears in the meniscus (articular cartilage disc), which means that it must be surgically removed. The subsequent lack of the outer meniscus results in the "bowlegs" misalignment. This form of leg axis misalignment is ten times more common than the X leg misalignment. Leg axis misalignments due to fractures of the thighs or lower legs, as well as the articular surfaces or the knee joint directly, are also common, as these can lead to different leg axis positions when they heal.
Diagnosis
The misalignments of the leg axis can best be recognized in a clinical examination by an experienced doctor, as well as by a X-ray of the entire leg, so that an operative reconstruction of the main load axis is possible.
The decisive factor here is how intact the part of the joint that is more heavily stressed by the relocation of the main load is. If already an advanced arthrosis of all joint sections, a correction of the leg axis is not indicated.
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
The knee joint is one of the joints with the greatest stress.
Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
How is the therapy of bow legs done?
That I If one "Growing up" in early childhood is here no therapy necessary. However, the course must be observed. These controls must be objectively comparable through reproducible measured values. Among other things, the Photo documentation, Outline drawings, Measurements of the Knee spacing with standing feet together or by repeating it roentgen.
Surgical interventions are in the form of Epiphysenodesis possible, but carefully weighed up with the possible complications and side effects. Further information can be found here: Leg straightening.
Is with those affected Buckle foot for compensation, it must also be treated. This is usually done by straightening the foot using a shoe insert with a raised inner edge (Longitudinal arch support).
The additional burden of the Knee joint, which shifts mainly to the inside of the knee, can through raised soles outside be achieved.
Therapy goal
A arthrosis should be avoided, therefore a congenital or acquired leg deformity is corrected in such a way that if the onset of osteoarthritis is present, at least further progression is prevented. The surgical therapy should distribute the weight evenly over the entire joint surface. By removing part of the Menisci However, the previous imbalance cannot be adequately compensated, as this would then lead to a renewed incorrect load, which permanently damages the joint substance.
The surgical method of choice is the osteotomy. An osteotomy is a severing of the bone. This is necessary to carry out the axis correction. The bone is cut into two parts with special bone chisels and an oscillating saw. A wedge is inserted into the incision that is now available in order to correct the axis of the legs and thus create a straight leg again.
Such a wedge is fixed with the help of plates and screws until it has healed. Like a "normal" broken bone, the osteotomized site must now grow back together. This takes at least 6 - 8 weeks to fully resilient.
A more elegant method to treat bow legs is the so-called "epiphysodesis".
This means the desertification of a growth plate. However, the prerequisite is that there is still growth. By deliberately obliterating a growth plate on one side, the bow leg grows straight until the end of growth.
The so-called bone age must be determined in order to achieve the right time for obliteration of the bow legs and correct outgrowth.
The body size can be determined from the bone age and the exact time of the epiphysis can be determined.
For detailed information on the operation, see: OP on bow legs
Course of the operation
If possible, corrective surgery is performed at the apex of the deformity. The bow leg bend is on Tibial head corrected.
With special bone chisels and a so-called oscillating saw, the bone is cut, a bone wedge is removed (or inserted, depending on the goal). This cut in the bone (Osteotomy) must then be secured with screws, plates or bone clamps until healing.
Such a bone cut then has to heal like a normal bone fracture and that takes about 6 - 8 weeks before full loading is possible again.
Before doing this, an X-ray image is made to check whether the leg has grown back together completely and whether the movement restrictions can be completely lifted and the leg can be fully loaded.
Complication of the operation
Operations always involve a certain risk, as they represent interventions in the physical organism. So there is also the Correction of bow legs Risks, but these are rare:
- Infections
- Blood clot formation with procrastination (thrombosis and embolism)
- Rebleeding with bruising
- Healing delay with necessary aftercare
Follow-up care and healing
The procedure is usually carried out in an inpatient setting and lasts for a week. After the operation, the leg may be partially loaded with 20kg from the beginning and after 6 weeks at the latest, depending on the X-ray findings the load can be increased.
Until the bony healing process is complete, measures are taken to strengthen the muscles and physiotherapy performed as well Lymphatic drainage (decongestant massages).
Working with crutches is possible as early as two weeks after the procedure if the work is mainly carried out at the desk.
A vehicle with automatic gearshift can be driven again immediately after surgery on the left leg, after surgery on the right leg or with normal gearshift after complete healing.
Swimming is particularly suitable for maintaining and rebuilding muscles and carries little risk of injury after the procedure, so that this sport can be performed again after two weeks.
However, all other sports should only be resumed after the bone has healed (X-ray control!).
Sports can usually be carried out better and longer after the operation than before, while the load is unevenly distributed in the joint.
