A deformity is any sort of distortion that makes a part of the body a different size or shape than it would be normally. Deformities can be congenital (present at birth), developmental (appearing later in childhood) or acquired (caused by injuries or illnesses that were not present at birth). Deformities can cause pain, discomfort and restriction to normal movement.

In adults, deformities can be seen as a result of previous illness or trauma. These deformities are seen in all parts of the body, at all angles and directions. Treatment of adult deformities is usually performed surgically because skeletal development has been completed. At this point, the degree to which the existing deformity affects the patient’s daily life, function, and appearance should be evaluated and the surgical decision made accordingly.

Knee deformities, commonly known as “O” or “X” legs, are one of the most common causes of pediatric orthopedic clinics. These deformities should be assessed in detail and it should be determined whether it is a condition that occurs in the course of normal growth or whether it is caused by other conditions

Diagnosis begins with a physical examination to determine the site of the deformity. The examination involves assessing the movement of joints surrounding the bones at the site of the deformity.

Radiological evaluation of the deformity is then performed. While X-rays are typically adequate at this stage, three-dimensional assessments using computed tomography (CT) scans may be employed for complex deformities or surgical planning. Blood parameters related to bone development and metabolism, such as calcium and phosphorus, can also be analyzed.

Detailed blood tests are performed for suspected conditions. Depending on the severity of the problem, the patient is referred to the endocrinology department and sometimes to the genetics department. Working in collaboration with these departments, the patient’s condition is assessed based on factors such as congenital presence and hormonal deficiencies, which then guide the determination of the appropriate treatment.

The correction of deformities involves the straightening of a bent or twisted bone that deviates from the normal alignment. Following the straightening procedure, the arm, leg, or foot regains its usual alignment and functionality.

Deformities can undergo correction through two distinct methods:

1. Acute correction: Executed all at once during a surgical procedure.
2. Gradual correction: Implemented slowly over the span of several weeks or months.

The selection of the optimal approach for each patient is determined by the doctor based on their individual circumstances.

To facilitate bone healing, patients are advised to abstain from nicotine in any form, ensure a diet rich in protein, and take vitamin and mineral supplements.

The most important criterion in treatment is age. The most common treatment in childhood is the placement of growth-guiding plates in areas of bone growth. These small plates straighten the bone in the desired direction.This method is simple to perform and less risky than more difficult surgeries such as fractures and bone fractures.

Within a cluster of deformities observed in both childhood and adulthood, the correction of such deformities necessitates bone cutting and fixation through osteotomy. The treatment plan is meticulously crafted to suit the specific needs of the patient.

Upon achieving proper bone positioning, the doctor introduces either an external or internal device to maintain the bone in its corrected alignment during the healing process. The internal device may take the form of an internal nail/rod or a metal plate. Occasionally, concurrent soft-tissue procedures are performed to enable the adjustment of muscles and nerves in response to the correction. Following bone healing, a second surgery may be undertaken to remove the internal device.

Alternatively, if an external fixation device is preferred, the patient is provided with explicit instructions and a schedule for adjusting the external fixator, gradually aligning the bone post-surgery. Once the healing process concludes, the external device is removed.

Regular postoperative monitoring holds significant importance. Patients undergo follow-up assessments involving X-rays and clinical examinations. Early postoperative care, particularly wound management, falls under the purview of the specialist who conducted the surgery.

An additional challenge that may arise during the distraction phase is the potential resistance of soft tissues (muscles, nerves, ligaments, tendons) to stretching, leading to increased tightness. To address tight muscles and nerves without resorting to surgery, a non-invasive approach involves focusing on stretching these muscles and nerves during physical therapy sessions. Throughout the distraction process, patients receive guidance to attend multiple physical therapy sessions per week.

In cases where necessary, surgical intervention can be employed to address muscle contractures. Subsequently, the objective shifts to enhancing the patient’s muscle strength through physiotherapy, facilitating a prompt return to their daily activities.