Internal tibial torsion Wheeless

Description: medial rotation of the tibia at the knee causes an intoeing gait;
- it is measured by the angular difference between transmalleolar axis & bicondylar axis of knee;
- may result in part to excessive medial ligamentous tightness;
- it is associated with metatarsus adductus in about one-third;
- infant exhibits in-toeing and may trip and appear clumsy;
- usually improves with growth;