Genu Valgum
Genu
Valgum is also known as knock knee. In the valgum deformity, the knees are tilted
toward the midline i.e Legs curve inwardly so that the knees are
closer together than normal. It can result from injury or septic destruction of
the lateral half of the lower femoral epiphyseal plate, results in arrested
growth of the lateral condyle of the femur. The continued growth of the medial condyle results in
unilateral knock knees.The typical gait pattern is circumduction, requiring
that the individual swing each leg outward while walking in order to take a
step without striking the planted limb with the moving limb. Not only are the
mechanics of gait compromised but also, with significant angular deformity,
anterior and medial knee pain are common. These symptoms reflect the pathologic
strain on the knee and its patellofemoral extensor
mechanism.
bilateral Valgum deformity can result
from condition which softens bone tissue. It may be due to-
- Rickets
- Osteomalacia
- Rheumatoid
Arthritis
- Muscular
paralysis of semimembranosus or semitendinosus
- Fracture
- May
be secondary to flat foot, osteoarthritis
The degree of knock knee is measured by the distance between
the medial malleoli at the ankle when the child lies down with the knees
touching each other.
Diagnostic Test
The Q angle which is formed by a line drawn from
the anterosuperior iliac spine through the center of the patella and a line
drawn from the center of the patella to the center of the tibial
tubercle, should be measured next. In women,
the Q angle should be less than 22 degrees with the knee in extension and less
than 9 degrees with the knee in 90 degrees of flexion. In men, the Q angle
should be less than 18 degrees with the knee in extension and less than 8
degrees with the knee in 90 degrees of flexion.
Treatment of Genu Valgum
Degree of deformity, muscle chart and ROM are measured. In
mild cases of Genu Valgum in young children,
wearing of boots with the inner side of heel raised by 3/8" inch and
elongated forward heel (Robert Jones heels) corrects the deformity.
In more complicated cases, the child requires a supracondyles
closed wedge osteotomy.
Post operative
Physiotherapy
- Gradual knee mobilization is
the main part of the treatment.
- Some heat modalities may be
given for relief of pain.
- Strengthening exercises for quadriceps,
hamstrings and gluteus
muscles are given.
- When the patient is able to walk, he is given correct
training for standing, balancing, weight transferring and
walking.
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