Orthopedics Book



Leg Rotation Evaluation in Children

Aka: Leg Rotation Evaluation in Children, Torsional Profile
  1. See Also
    1. Gait Evaluation in Children
    2. Foot Anatomy
    3. Clubfoot
    4. In-Toeing
    5. Out-toeing
    6. Metatarsus Adductus
    7. Congenital Vertical Talus
    8. Calcaneovalgus Deformity
    9. Pediatric Limp
    10. Foot Progression Angle
    11. Thigh-Foot Angle
    12. Hip Rotation Evaluation in Children
  2. Indications
    1. Limping Child
    2. Abnormal Gait in Children
  3. Criteria
    1. Foot Progression Angle
      1. Evaluate foot long axis relative to line of walking
      2. Based on line from heel to second to third toe
      3. Excessively negative Foot Progression Angle suggests In-Toeing
      4. Excessively positive Foot Progression Angle suggests Out-toeing
    2. Thigh-Foot Angle
      1. Patient lies prone, with knees flexed 90 degrees off table
      2. Assess angle between femur axis (line along length of bone) and foot axis (plantar line from heel to third web space)
      3. Thigh-Foot Angle internal rotation (medial rotation, In-Toeing)> 10 degrees suggests tibial torsion
    3. External Hip Rotation
      1. See Hip Rotation Evaluation in Children (includes normal ranges for age)
    4. Internal Hip Rotation
      1. See Hip Rotation Evaluation in Children (includes normal ranges for age)
  4. Interpretation
    1. Measurements 2 S.D. Outside the mean are considerd abnormal and often warrant specialty Consultation
  5. References
    1. Rerucha (2017) Am Fam Physician 96(4): 226-33 [PubMed]

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