X-legs - causes, therapy and symptoms

X-legs - causes, therapy and symptoms

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So-called X-legs are a misalignment of the knees between the thigh and lower leg, more precisely an axis misalignment at the knee joint, in which the lower leg deviates outwards. Those affected often find this to be unaesthetic, but the misalignment can also have health consequences, since the knee joint is stressed more than usual.

Vitamin D deficiency

Contrary to popular belief, X-legs are rarely congenital, but sometimes they are promoted by a congenital weakness of the connective tissue. Possible causes are, for example, rickets caused by vitamin D deficiency or polio.

Buckling feet

X-legs are more likely to result from an incorrect position of the feet of small children. Many children have light X-legs, but they grow together as they age. A common misalignment is the so-called sagging foot. Here the foot is slightly bent outwards and lies so flat on the floor that the padding of the foot does not grip. Overall, the legs are now not in the optimal position relative to the knee, the lower leg affects the knee, and the growth of the legs suffers.

Acquired X-legs

Acquired X-legs can have a number of other causes. Obesity puts a strain on the knees and can lead to leg misalignments; Disorders in the hormonal balance are also possible. Tumors can also cause x-legs, especially if they are located in the leg bones and knee. After the menopause, the bones often become brittle - this too can lead to malpositions. Inflammation in the knees and legs are also possible triggers. Furthermore, the malaligned leg can also develop as a result of osteoarthritis. Doctor botch is also very rarely the cause of X-legs.


The diagnosis of pronounced X-legs is simple at first: They can be recognized at a glance. Meanwhile, X-rays help with light X-legs. The symptoms also suggest the malposition. Affected people often suffer from inflammation of the knee and, in advanced stages, from osteoarthritis.

Important: An orthopedic surgeon can recognize early on from a misalignment of the feet if a child runs the risk of developing X-legs. In this preliminary stage, healing is still possible without much effort.


X-legs in the growth phase rarely need treatment. Many doctors explicitly advise against splints or even operations during childhood. Easily acquired X legs can also be relieved by body training. Sufferers learn to roll over the outside of their feet when walking, then over the entire ball of the foot and the big toe.

However, if the axis deviates by more than 20 degrees during puberty, surgical intervention is sometimes inevitable. The doctor then removes a small piece of the bone, for example, and thus corrects the malposition. Or the growth plate is stiffened by a splint, even then the leg can not continue to grow wrong.

Slight misalignments can be corrected with insoles in the shoes, which reinforce the inside under the foot and strain the knee joint in the outside direction.


Rickets is a disease in which the bones soften and deform, and the cause of which our ancestors did not know. The disease was described in England as early as the 17th century and was considered a disease of the fine people. At that time it was mainly the high society who got this disease: the poor, if they did not work in the mining industry, worked outdoors and were therefore given enough vitamin D. However, the nobility defined itself precisely by not having to work physically and it was important to do so by a pale one To demonstrate skin color. As a result, her skin did not take in enough sunlight, insufficient vitamin D was formed and those affected developed rickets due to the deficiency.

A mass phenomenon of early capitalism

The industrial revolution made vitamin D deficiency and thus rickets a mass phenomenon - especially among children. Children were preferred to work in mines because they fit in the narrow tunnels. In addition there was poor hygiene and completely inadequate nutrition, which weakened the body. Some of these child slaves buried underground did not see the sun for weeks in winter and pulled the coal carts up to twelve hours a day.

Children's bone disease

The rickets was then called "children's bone disease". Affected infants had “pits” on the back of their heads because the bones of the skull softened and widened hydrocephalus (water head). If the disease progressed, the skull rounded off, it lost its oval shape and looked like a ball. The base of the skull rose due to the softening and the entire skull sank down. A typical symptom was a water head with increased intracranial pressure and an exceptionally broad face.

Bent legs and ball belly

Axis of the legs were bent (mostly bow legs, but also X legs) and a ball belly developed. The chest deformed and the spine became crooked, as did the knees and joints. In the second year of life, the body weight had such an effect on the soft bones that the femoral neck lowered. The internal structure of the bones was rotten and incomplete, the hips without strength, the abdominal muscles could not function without the hips, and those affected suffered from chronic constipation.

The pull of the diaphragm on the soft chest created a "chicken breast" or "funnel breast". The wrists swelled, especially the ends of the forearm bones - the growth zones. The distance between the neck and shoulders was shortened due to the diseased cervical spine. In the end, the children's bones broke regularly.

In 1822 the Polish doctor Sniadecki recognized that farm children were less likely to suffer from rickets than those in Warsaw. In the late 19th century, Theodore Palm, a missionary, also observed that children near the equator had no rickets and suspected sunbathing as a possible cure and contraceptive strategy.

Cod liver oil and UV rays

In 1918, Sir Edward Mellanby successfully caused rickets in dogs by feeding them only porridge and keeping them indoors without the sun, while healing rachitic dogs with cod liver oil - the food that contains the most vitamin D. At that time this cod liver oil was known as a remedy for blindness and bone fractures.

McCollum recognized that the anti-rachitic effect in cod liver oil was a new substance and gave it the name Vitamin D. Hudshinsky discovered that the sun healed children with rickets. Steenbock and Black noted in 1924 that food exposed to UV rays could also cure rickets, which led to the great realization that UV light was able to convert a substance stored in food and skin into another form. The discoveries suggested a close relationship between sun exposure and vitamin D. In Germany rickets occur very rarely thanks to sufficient vitamin D.


Thanks to vaccinations, poliomyelitis has almost disappeared globally. Polio can lead to X-legs because the virus also attacks the nerves, and even especially the nerves that lead to the bone muscles. But when the muscles have no transmitters to the brain, they can no longer move - they become limp and the legs are misaligned. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch


  • German Society for Pediatric Endocrinology and Diabetology (DGKED): S1 guideline for vitamin D deficiency rickets, as of March 2016, (accessed September 6, 2019), AWMF
  • Christopher J. LaRosa: Hypophosphatemic Rachitis, MSD Manual, (accessed September 6, 2019), MSD
  • Adalbert I. Kapandji: Functional anatomy of the joints, Thieme Verlag, 6th edition, 2016

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