A Conservative Treatment Using Custom-Fabricated Static Knee-Ankle Foot Orthosis and Physical Exercise for Idiopathic Infantile Tibia Vara

Background: Infantile tibia vara (ITV) is a progressive developmental disorder of the proximal tibial physis leading to varus deformity and mechanical malalignment of the lower limbs. Early conservative management can prevent progression and reduce the need for surgery. Objective: To evaluate the effectiveness of combining custom-fabricated static knee-ankle-foot orthoses (KAFOs) with structured physiotherapy in correcting tibiofemoral (TF) and metaphyseal–diaphyseal angles (MDAs) and tibial torsion in children with early-stage ITV. Study Design: Descriptive observational study. Methods: Sixteen children aged 3–6 years with ITV (Langenskiöld stages I–III) received night-time custom-fabricated static KAFOs and a 12-month physiotherapy program focusing on strengthening, mobility, balance, and gait training. Radiographic and clinical assessments (MDA, TF angle, tibial torsion) were performed at baseline, 1, 3, 6, and 12-months. Data were analyzed using Friedman’s test for repeated measures and paired comparisons, with P < 0.05 considered statistically significant. Results: Significant improvements were observed across all parameters. Mean MDA decreased from 15.6° (standard deviation [SD] = 3.71) to 7.88° (SD = 1.82), TF angle improved from 17.44° (SD = 2.39) to 9.50° (SD = 2.30), and tibial torsion decreased from 17.9° (SD = 5.15) to 12.06° (SD = 3.04) ( P < 0.05). The greatest improvement occurred in children aged 3–4 years and at Langenskiöld stages I–II. Conclusions: The combined use of night-time KAFOs and structured physiotherapy resulted in significant correction of varus deformity and improved lower-limb alignment in early-stage ITV. This conservative, cost-effective approach provides a viable alternative to surgery when initiated early. ( J Prosthet Orthot. 2026;XX:XX–XX).