Lower-extremity rotational problems in children. Normal values to guide management
Staheli, L.T.; Corbett, M.; Wyss, C.; King, H.
Journal of Bone and Joint Surgery. American Volume 67(1): 39-47
1985
ISSN/ISBN: 0021-9355 PMID: 3968103 Document Number: 252900
We studied 1,000 normal lower extremities of children and adults in order to establish normal values for the rotational profile. The intrauterine position of the fetus molds the femur by rotating it laterally and molds the tibia by rotating it medially. These molding effects usually resolve spontaneously during infancy, and then genetically determined individual differences are unmasked. Rotational problems should be clinically evaluated and the findings compared with the normal values provided by this study. Out-toeing in infants, medial tibial torsion in toddlers, and medial femoral torsion in young children are extremes of a normal developmental pattern. In the vast majority, these rotational variations fall within the broad range of normal and require no treatment.