This condition is most prevalent in blacks. The infantile form is usually bilateral, progressive, and associated with significant internal tibial torsion. Most often it is seen in obese children of short stature who walked early. The juvenile form is usually unilateral, less deforming, and without internal tibial torsion. If this angle exceeds 11 degrees, most often the varus deformity will be progressive and represents Blount's Disease.
Treatment depends upon the age of the patient and the severity of deformity.
If epiphyseal change is minimal and the patient under three years old, on orthosis may be effective. For older children, surgery, and valgus external rotation osteotomy, will be required. Other rarer causes of pathologic bow leg deformity are rickets, meta-physeal dysplasia, osteochondromatosis, fibrous dysplasia, multiple epiphyseal dysplasia and osteomyelitis. Physiologic knock knee deformity is very common in children aged three to five years. In most instances, there will be spontaneous correction by age seven to eight.