Limb deformities can be congenital (present at birth), or develop at a later stage as a result of fracture, infection, arthritis or tumor. Congenital deformities of the lower limbs are developmental disorders that cause alterations in the shape and appearance of the legs. Several factors, including genetics, influence the fetal growth in the womb, and exposure to teratogenic drugs and chemicals can increase the risk of congenital deformities.
Some of the congenital deformities of the lower limbs include:
- Congenital talipes equinovarus: Congenital talipes equinovarus, commonly called clubfoot, is the most common foot deformity. The feet are twisted inward and downward at the ankles in such a way that the ankle or side of the foot comes in contact with the ground while walking, instead of the sole of the foot.
- Flat foot: Also known as pes planus, flat foot is a deformity of the feet, in which the arch running lengthwise along the sole of the foot has collapsed or has not formed at all. It may happen in one or both feet.
- Congenital vertical talus: Congenital vertical talus (CVT) is a rare condition in which the talus (heel bone) and navicular bones (ankle bone) of the child’s feet are abnormally positioned. This leads to a rigid flat foot with a rocker-bottom appearance. The hindfoot points downward to the floor while the forefoot points upwards. It occurs most frequently with other neuromuscular disorders such as spina bifida and arthrogryposis (multiple joint contractures present at birth).
- Calcaneovalgus foot: This postural deformity is located at the ankle joint, where the foot appears to be bent upwards. It occurs in newborns as a result of abnormal positioning in the womb.
- Congenital genu varus: Commonly called bowed legs, this is a condition seen in children under 2 years. The legs angle out at the knee joint in a way that a child stands with both feet joined and the knees apart. Generally, no treatment is required as the abnormality corrects as your child starts walking. Alternatively, special shoes, casts or braces may be ordered, or surgery performed in severe cases.
- Tarsal coalition: Tarsal coalition is a developmental deformity that occurs because of an abnormal connection between two bones at the back of the foot (tarsal bones). Most children with tarsal coalition are born with this condition, but symptoms usually appear between ages 9-16 once the bone matures.
- Metatarsus adductus: Metatarsus adductus is a common forefoot deformity where the bones in the front part of the foot are bent or turned inward, towards the body.
- Leg length discrepancy: Leg length discrepancy is a condition in which one leg is shorter than the other, leading to problems in posture and walking pattern. There may be associated pain in the back, hip, knee or ankle. It can be corrected by a reconstructive surgical procedure called limb lengthening.
The following procedures are commonly used to treat limb deformities:
- Bone Transport: A technique where bone is specifically cut (osteotomy) and allowed to regenerate filling a gap of missing bone.
- Limb Lengthening: The bone of the limb is broken and pulled apart gradually. New bone fills the gap as the fracture heals resulting in increased bone length.
- Correction of malalignment: A malaligned bone can be cut and realigned and stabilized in this position as it heals.