Cosmetic legs deformities

The cosmetic legs deformities are the conditions when a legs form is differed slightly from the ideal physiologic and aesthetic form. These deformities are not considered as pathological so the majority of orthopedists refuse to help patients with the cosmetic legs deformities. At the same time even slightly curved legs can lead to chronic emotional stress and disturbance of the social adaptation of a person in the society. It may be occurred in both men and women, however women suffer more due to features of women garments and modern fashions.

The legs deformities may be congenital and acquired. There are two basic types of the cosmetic deformities O- & X-shaped legs. The O-shaped legs form (bowed legs, bowl legs, genu varum) is the condition when legs are bowed outwards in the standing position. The bowing usually occurs at or around the knees, so that on standing with the feet together, the knees are far apart (Figure 1).

The X-shaped legs form (Knock-Knee, Genu valgum) is a condition when the legs are bowed inwards in the standing position. The bowing usually occurs at or around the knee, so that on standing with the knees together, the feet are far apart. The more frequent cosmetic deformities are bowed legs (Figure 2).

Conservative treatment of bowed legs and knock-knee does not correct them. So if a person with a cosmetic deformity eager to have straight legs there is only one way to correct legs form. It is an orthopedic operation. There are some different operative methods. However all techniques consist of common stages: 1) osteotomy which can be performed on the higher third of shins or lower third of femurs depending on deformities locations (Figure 3); 2) deformity correction, which can be performed immediately during the operation or gradually in the postoperative period; 3) fixation of the bones parts in correct position until the full consolidation which can be fulfilled using internal or external fixation devices.

The experience of many orthopedists shows that one time deformity correction using special sphenoid osteotomies can not be high-accurate that is an obstacle for its using in cosmetic goals.

The using of external fixators simplify the osteotomy and accordingly it decreases an operation risk. That's why it may be allowed to use it in the orthopedic cosmetology. The most convenient and safest external fixation technology is Ilizarov's method, which was modified especially for the cosmetic operations by another Russian orthopedist Mikhail Yegorov (Figure 4). This method uses the minimal traumatic osteotomy. Some authors term it as "corticotomy". The deformities correction is gradual and begun in about five days after the operation. Both physician and patient can control the correction degree and can stop the correction in any time, when they consider that correction is adequate. After the correction there is the fixation stage. Usually the whole treatment takes about 1-½ months, after that the fixation frames are removed and patients can walk without outside help and can return to their daily activities (Figure 5).

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