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ORTHOPAEDICS :: Growth-Related Disorders

Tibial Torsion

What is tibial torsion?

Tibial torsion is an inward twisting of the shin bones (the bones that are located between the knee and the ankle). Tibial torsion causes the child's feet to turn inward, or have what is also known as a "pigeon-toed" appearance. It is typically seen among toddlers.

What causes tibial torsion?

Tibial torsion can occur due to the position of the baby in the uterus. It also has a tendency to run in families. Typically, a child's walking style looks like that of his/her parents.

When the child is first learning how to walk, tibial torsion can create an intoeing appearance. As the feet toe in, the legs look like they are bowed. The bowed leg stance actually helps children achieve greater balance as they stand. Their balance is not as steady when they try to stand and walk with their feet close together or with their feet turned out. This may cause them to trip and fall.

How is tibial torsion diagnosed?

The diagnosis of tibial torsion is made by a physical examination by your child's physician. During the examination, the physician obtains a complete prenatal and birth history of the child and asks if other family members are known to have tibial torsion.

Other diagnostic procedures may include:

  • x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • computed tomography (Also called CT or CAT scan.) - diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

In addition, some physicians place ink or chalk on the bottom of the child's feet and have them walk on paper to evaluate the amount of intoeing the child has.

Treatment for tibial torsion:

Specific treatment for tibial torsion will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • the extent of the condition
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

The twisting of the shin bones usually improves with time. As the child grows, walking will become more normal, usually around 5 to 8 years of age.

Occasionally, braces or special shoes are prescribed by the physician.

Long-term outlook for tibial torsion:

Tibial torsion has a very good prognosis. Many cases correct themselves as the child grows. On rare occasions, tibial torsion can be severe and surgery may be required to straighten the shin bones.

It is important to know that tibial torsion does not lead to arthritis or any other future health problems.

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It is important to remember the health information found on this website is for reference only not intended to replace the advice and guidance of your healthcare provider. Always seek the advice of your physician with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician or 911 immediately.
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