Abnormalities of the Long Bones in the Lower Extremities

Current terminology and classification systems for limb defects have been summarized in the previous section.

In addition to the deformities resulting from failure of formation of parts, common defects of limb alignment, notably genu varum and genu valgum, are included in this section, as are patellar defects. The mechanisms involved in the development of lower limb malalignment can be extremely difficult to understand, given the complex interaction between bone structure, dynamics of bony growth, and the mechanical forces applied through the knee. For example, a depressed medial tibial plateau might be due to weakening of the bone, decreased growth rate at the medial portion of the tibial epiphysis, or excessive mechanical stress on the medial side of the knee. Similarly, it is impossible to establish reliably whether the medial tibial plateau is underdeveloped or the medial femoral condyle is abnormally prominent in cases in which the two defects coexist (e. g., in the nail-patella syndrome). These mechanisms are briefly mentioned below when appropriate.

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