Angular deformities of the lower limbs are common in pediatric orthopedic practice in lower-income countries. In a study from Rwanda, angular deformities of the lower limbs were the most common cause of musculoskeletal impairment in children . Limited access to services and delayed treatment often result in severe deformity not commonly seen in higher-income countries (Fig. 12.1). Areas with an increased prevalence, particularly in rural environments, raise the question of both nutritional and genetic causes, though few epidemiologic studies have been done. Deformities can originate at the physis, metaphysis, or diaphysis and include genu varum, genu valgum, and windswept deformities. Practitioners must identify the etiology of the deformity prior to planning limb realignment.
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