Incidence and Risk Factors of Rachitic Genu Varus in Preschool Children in a Paediatric Health Institute in Egypt as One of the Developing Countries

Sherif N.G. Bishay*, Mostafa H. A. El-Sherbini, Amre A. Azzam, Ashraf A. Lotfy
National Institute of Neuromotor System - Orthopaedics, 51 Al-Madina Al-Menawara Street, Al-Mouhandeseen, Giza 12411, Egypt

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© Bishay et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the National Institute of Neuromotor System - Orthopaedics, 51 Al-Madina Al-Menawara Street, Al-Mouhandeseen, Giza, Giza, Giza 12411, Egypt; E-mail:



Rachitic genu varus is one of the common conditions among the Egyptian children, despite the shinning sun of Egypt all the year.


The aim of the study was to estimate the incidence of rachitic genu varus among the Egyptian children, and to assess the risk factors contributing to it.

Patients and Methods:

This prospective study recruited a total of 250 consecutive children, being 130 males and 120 females, with rachitic bow legs or genu varus, between 2 - 4 years of age, together with 250 controls of the same age group, out of a total number of 1900 children with other types of rickets, and other children's orthopaedic diseases, who presented to the National Institute of Neuromotor System in Egypt between September 2014 to September 2015. The cases and the controls were subjected to clinical, laboratory biochemical, and plain radiographic examinations. Their parents were subjected to epidemiological, maternal, and nutritional questionnaires.


The calculations revealed high incidence (13.1%) of rachitic genu varus. The risk factors were low socioeconomic status, insufficient family income, poor housing conditions, lack of exposure to sunlight due to cultural practices, sole breast feeding, and inadequate supplementation of vitamin D to the children and the pregnant women. The p value was <0.05.


Vitamin D deficiency rachitic genu varus is a multifactorial condition in Egypt. Raising the standard of living, level of education, housings, and dietary supplementation of vitamin D to the pregnant women and infants are the solution.

Keywords: Genu varus, Malnutrition, Rachitic genu varus, Rickets, Vitamin D deficiency, Vitamin D supplementation.