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  Oct 15, 2018

Femoral Anteversion in Children

Femoral anteversion is a condition in which the thigh bone or femur is twisted inwardly, resulting in the in-turning of the knees and feet. The gait is typically pigeon-toed.

The stance of the affected toddler or child shows a bowed-leg appearance, because of the position of the femur. However, this actually improves the balance of the child. On the other hand, holding a position with the feet together or turned out can cause the child to become unsteady and fall more often.

The condition first manifests between the ages of 2-4 years, which is when the hip is maximally rotated medially. It is best seen outwardly at the age of 5-6 years. Femoral anteversion with about 30 to 40 degrees of torsion, present at birth, is considered a normal variant. This decreases over the childhood years to a low of 15 degrees by the time of completed bone growth.

Excessive medial torsion of the femur can cause in-toeing from early childhood onwards, and is present in about 10% of children. It is twice as common in girls and usually affects both femora. There is a strong familial link, with the mothers also having the same type of intoed gait. The result of this gait may be teasing for clumsiness, becaus