summary Internal Tibial Torsion is a common condition in children less than age 4 which typically presents with internal rotation of the tibia and an in-toeing gait. Diagnosis is made clinically with a thigh-foot angle > 10 degrees of internal rotation in a patient with an in-toeing gait.
How is internal tibial torsion diagnosed in children?
Examining the child with the patient sitting, standing and walking is important. When the child is sitting the rotation of the lower leg bone is measured against the upper leg bone. When the rotation of the lower leg bone is excessively in with very little rotation out, this is indicative of internal tibial torsion.
What age can tibial torsion be cured?
For these children, surgical de-rotation is an effective treatment. Typically, the best window for this is between 7 or 8 and 10 years of age. How can tibial torsion be prevented? Sleeping on the back, and lots of walking, running, and jumping may help prevent some tibial torsion.
How is lower leg torsion diagnosed for Flatfoot deformity?
Must rule out flatfoot deformity which would be made worse by the lower leg position (external tibial torsion). If the deformity is significant x-rays may be taken. The lower leg bone (transmalleolar axis) is measured relative to the upper leg bone (bicondylar axis of the proximal tibia). In an adult, it is approximately 14 degrees external.
Can a child outgrow internal tibial torsion?
Internal tibial torsion is one of the possible causes of in-toeing in young children. Most children outgrow their internal tibial torsion without any treatment. In rare cases, surgery may be recommended if internal tibial torsion doesn’t improve over time.
How long does internal tibial torsion take to heal?
Internal tibial torsion usually corrects itself in the first 6 to 12 months of walking. If the internal tibial torsion alone is 40 degrees at any time, or persists beyond 6 to 12 months of walking, consider having your child seen by an orthopedist for evaluation and possible treatment. How is tibial torsion treated?
How do you fix a twisted tibia?
If the tibia is still significantly twisted by age 9 or 10, then a surgery may be recommended to correct it. The surgery to correct internal tibial torsion is called tibial derotational osteotomy. During this procedure, the tibia is cut, rotated and fixed in a straighter position.
