Abstract
The presence or absence of structural changes in the tibial condyles serves to differentiate the two types of genu recurvatum. The presence of structural changes in one type1and the complete absence of these changes in the other can be explained by the variation in the underlying causative factors. The mechanism by which each type develops is determined by these different underlying causes. HYPEREXTENSION CHARACTERIZED BY SKELETAL CHANGES The chief underlying causative factor in the first group is the lack of sufficient power in the quadriceps group to lock the knee in extension against resistance. In a typical case the hamstrings have a normal rating, are not stretched out and may even be short. The calf group is normal, usually contracted and stronger than normal. A short achilles tendon develops and the calf becomes overdeveloped because, of necessity, the metatarsal heads are brought in contact with the floor when

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