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["In-toeing and out-toeing"]

Franck Accadbled1, Jean-Philippe Cahuzac

  • 1Unité d'Orthopédie Pédiatrique, Hôpital des Enfants, Toulouse.

La Revue Du Praticien
|April 6, 2006
PubMed

Insights

In-toeing and out-toeing are common pediatric orthopedic consultations caused by femoral and tibial torsion abnormalities. These conditions often resolve spontaneously during growth, with surgery reserved for persistent functional symptoms post-growth.

Area of Science:

  • Pediatric Orthopedics
  • Biomechanics
  • Developmental Anatomy

Context:

  • Rotational abnormalities of the lower limbs, commonly termed 'in-toeing' or 'out-toeing', are frequent reasons for pediatric orthopedic consultations.
  • These conditions arise from variations in femoral detorsion and lateral tibial torsion during a child's growth period.

Purpose:

  • To explain the etiology and diagnostic methods for lower limb rotational abnormalities in children.
  • To discuss the natural progression of these anomalies during growth and the lack of evidence for preventive treatments.
  • To outline the indications for surgical intervention in cases of persistent functional symptoms.

Summary:

  • Femoral and tibial torsion anomalies lead to in-toeing or out-toeing, affecting children from birth through growth.
  • Diagnosis involves analyzing knee-foot alignment during gait and measuring femoral and tibial torsion.
  • While these anomalies can fluctuate spontaneously, surgical derotation osteotomies are considered only for persistent functional issues after growth cessation.

Impact:

  • Provides clarity on the natural history and management of common pediatric lower limb rotational issues.
  • Informs parents and clinicians about the typical progression and the limited role of early intervention.
  • Highlights the criteria for surgical consideration, emphasizing functional deficits post-growth.

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