Genu Valgum

Excerpt

Genu valgum or "knocked knees" are part of the coronal plane deformities of the lower extremity. The majority of patients are asymptomatic and have no functional limitations. This condition can be preceded by flat feet and occasional medial foot and knee pain. Children start developing physiologic genu valgum starting by age 2, and it becomes most prominent between ages 3 to 4. After that, it typically decreases to a stable, slightly valgus position by age 7 years. In the adolescent age group, minimal, if any, change in this alignment is expected. Intermalleolar distance has been used to assess the degree of genu valgum. It is the distance between the medial malleoli in a standing patient with touching medial femoral condyles. Intermalleolar distances greater than 8 cm is considered pathologic. Rarely, in cases where valgus alignment continues to increase, it can be associated with an out-toed gait, lateral subluxation of the patella, and rubbing of the knees together as the child ambulates.