Evaluation and Treatment of Angular Deformities

Abstract

The infant’s lower limbs are aligned in varus from birth until approximately 18–24 months of age, after which they are in valgus. Valgus peaks between 3 and 4 years, and adult alignment (5–7° valgus) is achieved at approximately 7–8 years. When faced with a deformity, the surgeon must identify those that are pathologic and affect function or cosmesis, cause pain, or will have consequences later in life. Coronal plane deformities can be due to one or more of the following causes: angulation of the femur and/or tibia, intra-articular bony deficiencies at the knee, and ligamentous hyperlaxity. Physical examination along with full-length standing radiographs and other pertinent imaging modalities are used to individualize treatment.