Posteromedial Tibial Bowing


- Discussion:
    - unlike anterolateral bowing, this disorder is not assoc w/ other anomalies (like neurofibromatosis) nor is it associated w/  tibial frxs or pseudarthrosis,
          such as congenital pseudarthrosis of tibia;
    - clinical findings:
          - posteromedial bowing
          - calcaneal valgus
          - limb-length inequality;
          - triceps surae weakness;

- Limb Shortening: (see: limb growth deformities)
     - limb is shortened 1 -1.5 cm at birth;
     - some will have limb length discrepancies avg 4.0 cm at maturity;
     - growth inhibition usually remains as a constant percentage over time, thus allowing future equalization procedures can be planned.
     - treatment options:
            - casting:
            - contralateral epiphysiodesis;
            - ipsilateral limb lengthening;

- Bowing:
     - angular deformity corrects spontaneously, but medial bowing may persist.
     - occasionally, osteotomy is necessary to correct medial bowing.
     - no orthotics are necessary and the patient should be observed.

- Calcaneal Valgus:
     - calcaneal valgus foot position resolves gradually



Posteromedial bowing of the tibia progression and discrepancy in leg lengths

Congenital posteromedial bowing of the tibia and fibula



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, June 1, 2012 8:19 am