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Intoeing–Tibial/Femoral Torsion, Pediatric

George D. Gantsoudes, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Intoeing, as a presumptive diagnosis, results in numerous orthopedic consultations.

  • Causes of intoeing are most frequently one or more of the following: metatarsus adductus, internal ...

DIAGNOSIS

HISTORY

  • Varies based on age of presentation

  • The most common reasons for malalignment visits in the preambulatory infant are either intoeing due to metatarsus adductus/internal tibial torsion o...

TREATMENT

  • The younger child (<8 years) should spontaneously resolve minor internal torsion of the tibia and femur.

  • Corrective shoes, Denis-Browne bars, twister cables, stretching, and formal physica...

ONGOING CARE

PROGNOSIS

  • Most patients are discharged with follow-up “as needed” with instructions to return if the problem hasn’t improved over a period of 2 years or if the problem acutely worsens.

  • Pati...

ADDITIONAL READING

  • Craig CL, Goldberg MJ. Foot and leg problems. Pediatr Rev.  1993;14(10):395–400. [View Abstract on OvidInsights]

  • Fuchs R, Staheli LT. Sprinting and intoeing. J Pediatr Orthop. ...

CODES

ICD9

  • 754.43 Congenital bowing of tibia and fibula

ICD10

  • Q68.4 Congenital bowing of tibia and fibula

SNOMED

  • 108761000119101 Congenital internal tibial torsion (finding)

  • 275864001 On examination - intoe...

FAQ

  • Q: Are special shoes or braces ever indicated for tibial torsion?

  • A: There is no convincing evidence that any of these treatments truly alter the natural history of the condition. The situation wil...

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