Lower Limb Variants

There is a wide variation in lower limb development, and minor variants, such as flat feet or knock-knees, are a common cause of parental concern. Sometimes they can be confused with indicators of underlying pathology.

Here we describe the common physiological variants, indications for concern and when to refer for specialist opinion (usually to paediatric orthopaedics).

We include descriptions for flat feet, toe walking, Genu Valgum (knock-knees), Genu Varum (bow-legs), Out-toeing and In-toeing, Curly Toes, Clubfoot and delayed walking

The figure below shows the development of leg alignment in children at different ages 

 Further information on physiological variants is available.