II. Definition
- Tibia internally rotated with toe pointing inward
III. Epidemiology
- Common pediatric leg rotation variant
- Most common cause of In-Toeing (typically presenting in toddlers)
IV. Physiology: Mean tibial torsion
- Adult 15-20 degrees
- Newborn 5 degrees
V. Signs
- Observation of child walking
- Knee caps point forward
- Femur external
- Tibial internal rotation cancels femur rotation
- Foot points inward (due to tibial rotation)
- Internally rotated thigh foot angle
- Negative Foot Progression Angle
- Knee caps point forward
- Assess Thigh-Foot Angle
- Assess for Tibial Rotation in Children
VI. Course
- Spontaneous resolution in 95% of children by age 5-8 years old
VII. Management
- Avoid braces, night splints, shoe modifications, Orthotics, serial Casting
- Treat any associated Metatarsus Varus (In-Toeing)
- Surgical indications (rare)
- Children >8 years with Thigh-Foot Angle >15 degrees (>3 SD above mean) AND
- Severe functional or cosmetic abnormality not expected to improve
VIII. Prognosis
- Persistent Internal Tibial Torsion is not associated with significant morbidity, Disability or joint degeneration
IX. References
Images: Related links to external sites (from Bing)
Related Studies
Concepts | Finding (T033) |
SnomedCT | 299228008 |
Dutch | inwendige tibiatorsie |
French | Torsion du tibia interne |
German | interne tibiale Torsion |
Italian | Torsione tibiale interna |
Portuguese | Torção tibial interna |
Spanish | Torsión tibial interna, torsión interna de tibia, torsión tibial interna (hallazgo), torsión tibial interna |
Japanese | 脛骨内捻転, ケイコツナイネンテン |
Czech | Interní tibiální torze |
Hungarian | Tibialis belső torsio |
English | Internal tibial torsion, Internal tibial torsion (finding) |