Orthopaedic deformities 🦴 are common in children and adults, ranging from benign developmental variants to serious structural abnormalities.
They can cause pain, gait disturbance, functional impairment, and psychosocial impact.
Understanding the pathophysiology helps distinguish between physiological changes (which resolve with growth) and pathological conditions that require intervention.
🔑 Mechanisms include:
- 🧬 Abnormal bone growth or modelling (e.g., rickets, Blount’s disease)
- 💪 Neuromuscular imbalance (e.g., CP, polio)
- 🦵 Ligamentous laxity or soft tissue contractures
- ⚡ Skeletal dysplasia or congenital anomalies
| Deformity |
📖 Description |
🧬 Pathophysiology |
⚠️ Causes / Risks |
🧪 Diagnosis |
💊 Management |
| Scoliosis |
Lateral spinal curvature with vertebral rotation |
Asymmetric vertebral growth → rotation & curvature |
Idiopathic (80%), congenital anomalies, neuromuscular disorders (CP, SMA) |
Exam, X-ray (Cobb angle), MRI if atypical |
Bracing (mild), physiotherapy, spinal fusion if severe |
| Clubfoot (Talipes Equinovarus) |
Rigid inward & downward turned foot |
Shortening of Achilles tendon + abnormal talus/calcaneus alignment |
Congenital, neuromuscular, intrauterine positioning |
Clinical exam, antenatal ultrasound |
Ponseti casting (gold standard), bracing, surgery if resistant |
| Flatfoot (Pes Planus) |
Loss of medial arch of foot |
Ligamentous laxity or abnormal tendon support (tibialis posterior) |
Physiological in infants, obesity, neuromuscular disorders |
Clinical exam, weight-bearing X-ray if rigid |
Observation (flexible), orthotics, surgery if rigid/painful |
| Developmental Dysplasia of the Hip (DDH) |
Femoral head not properly seated in acetabulum |
Abnormal acetabular development → instability & dislocation |
Female, breech, family history, first-born |
Ortolani/Barlow, hip US (infants), X-ray (older) |
Pavlik harness (infants), closed/open reduction, surgery if late |
| Bowlegs (Genu Varum) |
Outward bowing of legs |
Abnormal tibial growth plate activity or vitamin D deficiency |
Physiological (toddlers), Blount’s disease, rickets |
Clinical exam, standing leg X-ray |
Observation if physiological, bracing/surgery if pathological |
| Knock Knees (Genu Valgum) |
Inward angulation, knees touch but ankles apart |
Asymmetric femoral/tibial growth or metabolic bone disease |
Physiological (2–7 yrs), rickets, trauma, obesity |
Clinical, X-ray (femoro-tibial angle) |
Observation if mild, bracing, surgery if severe/persistent |
| Leg Length Discrepancy |
Unequal leg lengths causing gait abnormality |
Growth plate arrest, asymmetrical growth, or bone loss |
Congenital, trauma, tumour, infection |
Leg measurement, X-ray scanogram, CT/MRI if complex |
Shoe lifts (mild), epiphysiodesis or limb lengthening if >2 cm difference |
| Osgood-Schlatter Disease |
Painful tibial tuberosity prominence |
Microtrauma at patellar tendon insertion during growth spurts |
Adolescent athletes, rapid growth phases |
Clinical diagnosis, X-ray to exclude other pathology |
Rest, ice, NSAIDs, physiotherapy, brace if persistent |
| Kyphosis |
Excess forward spinal curvature (humpback) |
Vertebral wedging or postural muscle imbalance |
Postural, Scheuermann’s disease, congenital, osteoporosis |
Clinical exam, X-ray spine, MRI if structural anomaly |
Physio (postural), bracing, surgery if progressive/severe |
