There are multiple etiologies for tibial bowing (see Etiology). Tibial bowing specifically refers to bowing of the diaphysis of the tibia with the apex of the deformity directed anterolaterally, anteromedially, or posteromedially. Each type of bowing tends to have a classic etiology.
Anterolateral bowing is associated with pseudarthrosis of the tibia and neurofibromatosis. Anteromedial bowing is associated with fibular hemimelia. The focus of this article is on posteromedial tibial bowing.
Posteromedial bowing is a congenital bowing of the tibia (with the apex directed posteriorly and medially) and a calcaneovalgus foot deformity. Both of these deformities tend to resolve with little clinical disability; however, a leg-length inequality commonly develops that often requires treatment. If a significant leg-length inequality results, the patient will have an abnormal gait and may be at risk for increased back pain or deformity. Treatment options vary depending on the degree of limb-length inequality, age of the patient, expected height, and desires of the patient or family. Treatment options include slowing the growth of the longer limb or lengthening the shorter limb.
Synonyms and related keywords:
bowing of the diaphysis of the tibia, posteromedial bowing, calcaneovalgus foot deformity, leg-length discrepancy, limb-length inequality
Author: James McCarthy, MD 2007