Tibial Torsion eMedicine Orthopedics

Description: Femoral anteversion decreases from approximately 40° at birth to approximately 15° at maturity. Lateral rotation of the tibia increases from approximately 5° at birth to approximately 15° at maturity.
Tibial torsion: Medial torsion improves with time. Lateral torsion often worsens because the natural progression is toward increasing external torsion. The ability to compensate for tibial torsion depends on the amount of inversion and eversion present in the foot and on the amount of rotation possible at the hip. Internal torsion causes the foot to adduct, and the patient tries to compensate by everting the foot and/or by externally rotating at the hip. Similarly, persons with external tibial torsion invert at the foot and internally rotate at the hip.
Femoral torsion: The natural history of this condition is to resolve by the time the patient is aged 8-9 years. Beyond this age, all remodeling will have occurred, and any further correction is due to a conscious modification of posture.
Synonyms and related keywords: in-toeing, intoeing, pigeon toeing, internal torsion, femoral torsion, femoral anteversion
Patel & Herzenberg 2004