Femoral Torsion

• angular difference between the femoral neck axis and the transcondylar axis of the knee
• birth averages 40 degrees of antervesion, by 8y/o averages the adult value of 15 degrees
• increased femoral anteversion is most common cause of in-toeing in early childhood

Femoral Torsion Clinical Evaluation

• characteristically sit in the W position and run with an eggbeater-type motion due to IR of thighs during swing phase
• IR is increased, ER is decreased

Femoral Torsion Treatment

• generally no treatment necessary
• OR considered for >8y/o with marked cosmetic or functional deformity, anterversion >50 and IR >80 degrees.  Proximal or distal femoral osteotomy