Peds

External Tibial Torsion

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External Tibial Torsion

  • See Also
  1. Femoral Retroversion
  2. Pes Planus
  3. Out-toeing
  4. Pediatric Leg Disorder
  5. Pediatric Limp
  6. Gait Evaluation in Children
  • Epidemiology
  1. Presents at age 4 to 7 years old
  • Pathophysiology
  1. Tibia externally rotates with growth, up to age 4 to 7 years old
  • Signs
  1. Thigh foot angle >30 degrees
  2. Out-toeing
    1. Foot Progression Angle positive (externally rotated foot)
  • Management
  1. Surgery is typically avoided until after age 10 years old
  2. Surgery may be considered for Thigh foot angle >20-30 degrees
  3. High complication rate with surgery
  • Complications
  1. Patellofemoral Syndrome
  2. Knee instability
  • References
  1. Baird (2025) Am Fam Physician 111(2): 125-39 [PubMed]
  2. Rerucha (2017) Am Fam Physician 96(4): 226-33 [PubMed]