Congenital Posteromedial Bowing of the Tibia (Congenital Tibia Recurvatum)

Congenital posteromedial bowing of the tibia is a rare, unilateral condition of variable severity that is usually associated with a calcaneovalgus foot at birth. Congenital posteromedial bowing is considered to be benign in that spontaneous improvement may be expected (Fig. 1(a–b)). In contrast, the opposite deformity pattern (anterolateral bowing) is more worrying because it is usually associated with pathologic conditions such as pseudarthrosis of the tibia, osteogenesis imperfecta, neurofibromatosis, and fibula dysplasia. The etiology of posteromedial bowing is unknown. The foot deformity responds quickly to stretching exercises but the bony deformity takes longer to improve. The remodeling of the tibial bowing may be incomplete and is usually associated with a variable leg-length discrepancy that may require limb reconstruction techniques. The size of the discrepancy may be related to the severity of the initial bowing.