الفهرس 
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Abstract
ITV is a growth disorder of the medial aspect of the proximal tibial physis, with abrupt medial angulation of the proximal tibia distal to the epiphysis, leading to varus angulation of the proximal tibia and medial rotation if the tibia.
Risk factors of ITV include obesity, female gender, afro-american lineage, walking at early age, and positive family history.
Clinically a non-tender bony prominence or “beak” may be palpable over the medial tibioal condyle, excessive medial tibial torsion, pronated feet, and shortening of the involved leg may be present.
Radiographic features of ITV include abrupt medial angulation “beaking” of the medial cortical wall of the proximal tibial metaphysis, straight lateral wall of proximal tibial metaphysis, the MDA greater than 11o, the FTA greater than 15o and the FTR was found to be a better barometer to differentiate ITV from physiologic bowing than tibial MDA.
Non-operative management includes observation if within the first 2 years of life, orthotics when age 2-3 years, MDA > 11o and TFA > 15o, KAFO is designed to provide rotational support 24 hrs/day. It takes 1 year to determine effectiveness.
Osteotomy of the proxiaml part of the tibia is indicated for the child who is first seen for treatment after age three, for the child 30 – 36 months old who is a poor candidate for brace therapy, and for the three-year-old child who has persistent genu varum despite brace therapy. Multiple .