Vol. 11, Issue 4 (2025)

Introduction: Genu valgum, commonly referred to as knock knees, is a physiological condition typically observed in children aged 3 to 6 years. It is marked by an inward angulation of the knees, causing them to touch while the ankles remain apart. This condition generally resolves spontaneously by the age of 7 or 8. However, when genu valgum persists beyond this age, it may become pathological due to causes such as metabolic bone disorders (e.g., rickets), trauma, growth plate disturbances, tumors, infections, skeletal dysplasias, or neuromuscular disorders like cerebral palsy. In such cases, medical or surgical intervention is often required to prevent functional limitations and long-term deformity.

Case Presentation: A 15-year-old girl presented with bilateral knee deformity, reporting noticeable "knocking" during ambulation. Despite having a normal knee range of motion, the deformity had not been addressed in childhood. Radiographic evaluation revealed closed physis and fully matured bones.

Surgical Procedure: Pre-operative evaluation revealed an intermalleolar distance of 22 cm, with the tibiofemoral angle measured at 24° on the right side and 18° on the left. The patient was treated with bilateral distal femoral osteotomies using a medial closing wedge technique. During the procedure, care was taken to preserve the integrity of the lateral femoral cortex. Fixation was achieved using Kirschner wires (K-wires) to maintain alignment post-correction.

Post-Operative Course: Passive range of motion exercises began in the second postoperative week. The Kirschner wires were removed one and a half months following the operation. By three months, the patient achieved full knee motion, normal weight-bearing capacity, and was able to squat comfortably. Final measurements indicated a corrected tibiofemoral angle of 5° bilaterally and a resolved intermalleolar gap.

Conclusion: This case demonstrates that distal femoral wedge osteotomy with K-wire fixation is a reliable and effective method for correcting genu valgum in skeletally mature patients. Beyond delivering excellent functional and radiological outcomes, this technique is also cost-effective and particularly suitable for use in low-resource settings. Its simplicity, affordability, and favorable results make it an excellent option for treating patients from economically disadvantaged backgrounds where access to advanced implants and surgical technologies may be limited.