Coronal angular deformities of the lower limbs, such as bow legs and knock-knees, are frequently observed in childhood. While many cases are considered normal and resolve on their own, when these deformities become significant and progressive, they can disrupt the quality of life, leading to gait disturbances, pain, and in severe instances, joint instability. Additionally, these deformities may have indirect effects on other joints like the hip and ankle, and most importantly, they increase the risk of early osteoarthritis in the knee .

It is generally accepted that a significant deformity that persists up to preadolescence will not correct spontaneously. Physiological alignment of the lower limb is crucial for the symmetrical distribution of weight over the surfaces of the joints, especially the knee. Indeed, severe coronal malalignment has been linked to knee pain, altered gait, and occasionally patellofemoral problems .

Inclusion Criteria:

1. Both gender (males and females)
2. Children ≥3 years old and growing children 2 years at least remaining in growth ( skeletal immature)
3. Cases with progressive knee deformities around knee at any side.

Exclusion Criteria:

• 1. Physeal closure.

  2. Physiological deformity in younger ages that could be managed conservatively ( age < 3 years )

  3. Cases with metabolic or chronic illness conditions unresolved.