GENU VAR UN' This deformity is just opposite to genii valgum. In erect attitude ankles and heels are in contact while the knees stand wide apart (bow legs). Femur and lower leg participate equally as a rule in the distor tion. The foot is correspondingly pronateil upon the leg (see the accom panying cosy yam rachitica).
The deformity is Ay bi lateral; in some cases it is com bined with genii valgum of the opposite side.
In regard to etiology it may be stated that some children are born with bow-legs, a condition which becomes aggravated with the increase of weight. As men tioned above, I had occasion to observe that the original oat ward bowing of the femur was compensated for by an outward bowing of the lower leg.
Spontaneous recovery from this deformity is very frequent, and a physician is seldom con snited in these cases because of the well-known fact that chil dren "outgrow" the deform ity, provided it is not too pro nounced.
The prophylaxis and treat ment are identical with the meas ures adopted for gene valgum. In mild cases recovery may be left to nature. In addition a general antirachitic treatment must be instituted. Sun baths, salt baths, and a diet to prohibit too large a production of fat are indicated.
Braces that are applied to overcome the deformity by traction or pres slue with springs are favored, but are not very efficient. I employ t hem to avoid relapses after operation or corrective osteoclasis or osteotomy.
The point where osteotomy should be performed depends on the vertex of the curvature. In uniform marked deformities the middle of the femur and lower leg (Fig. 103) are the most suitable points for opera tion (sec following section).