s beyond the foot.
The splint is fixed above and below by bandages, and the projecting
knee is drawn towards it by a few turns of elastic webbing. A method
specially applicable to hospital out-patients, is to straighten the
limbs as far as possible under anaesthesia, and apply a plaster
bandage; the bandage is renewed at intervals of three weeks until the
deformity is corrected. Whatever plan is adopted, it must be
persevered with for at least six months, until the rickety changes in
the bones have been entirely recovered from.

If the child is approaching the age of five or six before it comes
under treatment, or if the deformity does not yield to treatment by
splints, it is better to straighten the limb by _osteotomy_.

In _adolescent knock-knee_ the patient seeks advice because of the
deformity or of pain after exertion, especially at the medial side of
the epiphysial junctions, of being easily tired, and of incapacity for
any occupation involving standing. The bones are coarse and badly
formed, and there is frequently a spinous process projecting downwards
from the medial side of the tibia about three finger-breadths below
the joint.

When the deformity is bilateral, the patient abducts the thigh and
rotates the limb outwards at the hip to disguise the deformity, and to
allow the projecting knees to pass each other. He usually supinates or
inverts the foot, with the object of bringing the whole length of the
lateral border of the sole into contact with the ground. Flat-foot is
exceptional. The boots are usually more worn along the lateral than
along the medial border of the sole and heel.

No apparatus that allows of the patient walking is of any value. If
the deformity is marked, there should be no hesitation in having
recourse to operation by one or other of the various methods of
osteotomy.

In severe cases it may be found that when the deformity is corrected
by osteotomy, the patella shows a tendency to be dislocated laterally
on flexion of the knee. This may be prevented by putting up the limb
in the attitude of slight genu varum.

The most difficult cases to treat are those in which, owing to curving
of the lower part of the shaft of the femur with the convexity
forwards, the knee is permanently flexed and cannot be completely
extended.

#Other forms of genu valgum# are relatively rare. There is a
congenital form arising from faulty position of the limbs _in utero_;
a traumatic form following fractur