Torsion of the lower limb in children

In most cases, torsional deformities in healthy children are minor and self-limiting. Parental education, reassurance, a handout, and an offer to see the child again are all recommended.

If there is no underlying disorder or condition (e.g., slipped capital femoral epiphysis, cerebral palsy, hip dysplasia, etc), no treatment, other than observation, may be offered. Unnecessary treatment for intoeing and out-toeing may be harmful. Operative treatment may be appropriate for fewer than 1% of patients in cases where the condition is severe, and may cause disability.

Parents may rationalize frequently tripping and falling in their children on the basis of intoeing or flat feet; however, there is no evidence to support this perception. Tripping is common in toddlers because they do not automatically lift their toes up.

Suspected deviations in growth and development should be brought to the attention of a pediatrician.

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