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Posteromedial Tibial Bowing

- Discussion:
    - unlike anterolateral bowing, this disorder is not assoc w/ other anomalies (like neurofibromatosis) nor is it associated w/  tibial
          frxs or pseudarthrosis,  such as congenital pseudarthrosis of tibia;
    - clinical findings:
          - posteromedial bowing
          - calcaneal valgus
          - limb-length inequality;
          - triceps surae weakness;

- Limb Shortening: (see: limb growth deformities)
     - limb is shortened 1 -1.5 cm at birth;
     - some will have limb length discrepancies avg 4.0 cm at maturity;
     - growth inhibition usually remains as a constant percentage over time, thus allowing future equalization procedures can be
     - treatment options:
            - casting:
            - contralateral epiphysiodesis;
            - ipsilateral limb lengthening;

- Bowing:
     - angular deformity corrects spontaneously, but medial bowing may persist.
     - occasionally, osteotomy is necessary to correct medial bowing.
     - no orthotics are necessary and the patient should be observed.

- Calcaneal Valgus:
     - calcaneal valgus foot position resolves gradually

Posteromedial bowing of the tibia. Progression and discrepancy in leg lengths

Congenital posteromedial bowing of the tibia and fibula