Normal and Abnormal Torsional Development in Children

This study presents findings in a series of 123 children with intoeing gait. The intoeing was caused by increased femoral anteversion (IFA) in 70% of the cases, and internal tibial torsion (ITT) in 30%. Rotation of the hips, thigh-foot angle, Q-angle, and computed tomography measured anteversion and tibial torsion divided the two groups very clearly. In the IFA group, 40.3% of the patients presented with an externally rotated tibia and 59.7% had an internally rotated tibia. In the ITT group, the anteversion was normal for age and the tibial torsion was significantly decreased. Eighty children who corrected their intoeing gait, and of whom 83.4% had IFA, were also reviewed: a decrease in anteversion was observed in 20.5% of the patients; 62.9% showed no decrease in anteversion.