As bow legs are common before the age of two, so knock knees are common in the age group two to five.

As with bow legs and in-toeing, there is little functional impairment from this condition but the appearance is unattractive and may require treatment.

Knock knees are thought to be due to posture and sleeping habits, although some researchers doubt this.

Sleeping on the back with the legs and feet rotated outwards like a frog, may be the cause. Or a child may sleep on his face with the legs extended and the feet turned in, but apart from each other.

Knock knees usually do not require treatment unless the child, standing with knees together, has the ankles at a greater distance than 10 cm (4 in).

Normally, if treatment is required, the legs can be placed in splints during sleep. Rarely are operations necessary.

It is wise for parents to avoid “folk lore” treatments, such as making the child wear his shoes on the opposite feet. This doesn’t work.

If parents are worried by their children’s feet and legs, medical advice should be sought. Most cases will not require treatment and will spontaneously revert to normal.

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