Tibial Torsion

• most common cause of intoeing from 1-3 y/o
• thought to be caused by intrauterine postioning

Tibial Torsion Clinical Evaluation

• thigh-foot axis, transmalleolar axis
• c/o clumsy, trips frequently

Tibial Torsion Treatment

• generally resolves spontaneously by age 4
• treated with supramaleolar osteotomy with plate fixation for ER >30 and IR >15 in pts >8yrs old

External Tibial Torsion; associated with NM disease, tends to increase with age, can lead to patelofemoral pain and patellofemoral instability