Diagnosis may be facilitated by measurement of the metaphyseal-diaphyseal angle, between a line drawn perpendicular to the tibial shaft and a line drawn between the medial and lateral aspects of the tibial metaphysis. Bracing is the initial treatment for tibia vara in the patient under 3 years of age. In older children or if bracing has failed, a proximal tibial valgus osteotomy before 4 years of age is recommended. If over 4 years, a physeal-bar resection and a lateral proximal tibial hemiepiphysiodesis may be useful to reduce recurrence of deformity, and elevation of the depressed medial epiphysis can restore articular congruity. Recommended treatment is a lateral proximal tibial hemiepiphysiodesis, followed by an osteotomy if necessary.
Treatment is to restore phosphates and vitamin D, followed by surgery at skeletal maturity.
Renal failure or renal osteodystrophy causes femoral and tibial varus bilaterally. Treatment should be postponed until the renal status has been stabilised. Rarely, metaphyseal chondroplasia causes genu varum due to abnormal chondroblast function and chondroid production. Short stature and mental retardation may be present. Achondroplasia, causing dwarfism by defective endochondral bone formation, results in physiological tibia vara which doesn't correct with growth due to overgrowth of the fibula.