Peds

Femoral Retroversion

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Femoral Retroversion

  • See Also
  1. Out-toeing
  2. Pediatric Leg Disorder
  3. Pediatric Limp
  4. Gait Evaluation in Children
  5. External Tibial Torsion
  6. Pes Planus
  • Definitions
  1. Femoral Retroversion
    1. External rotation of the femoral long shaft
  • Epidemiology
  1. Common disorder in newborn and non-ambulatory infants
  • Pathophysiology
  1. Typically related to hip contracture from intrauterine positioning
  • Signs
  1. Feet externally rotated (Out-toeing)
    1. May be nearly 90 degrees (charlie chaplin walk)
  2. Hip internal rotation decreased
  3. Hip external rotation increased
  • Imaging
  1. Indicated in persistent findings after age 3 years
  2. Obtain xray Pelvis, XRay Hip and xray lower extremity
  • Differential Diagnosis
  • Other Causes of Femoral Retroversion with Later Onset
  1. Slipped Capital Femoral Epiphysis (age > 8 years)
  2. Legg-Calve-Perthes (age 4 to 9 years)
  3. Leg Stress Fracture
  • Management
  1. Referral to pediatric orthopedics if persistent findings after age 3 years old
  2. Typical age of surgical corrective osteotomy (if persistent and significant) is 10 years old
  • Course
  1. Typical improvement in the first year of walking
  2. Persistent findings after 3 years warrants investigation
  • References
  1. Rerucha (2017) Am Fam Physician 96(4): 226-33 [PubMed]