Video Explanation: Limb Torsion – What Parents Need to Know

Lower limb torsions are physiological rotations that bones (femur and tibia) undergo during development. These torsions determine how feet orient during walking and are often the cause of in-toeing or out-toeing. **What is torsion?** Every long bone has a certain degree of "twisting" on itself. In the femur, we speak of anteversion (forward rotation) or retroversion (backward rotation). In the tibia, of internal or external torsion. **Normal evolution:** - **At birth:** Newborns have femoral anteversion of about 40° and slight internal tibial torsion. - **During growth:** Femoral anteversion gradually decreases to 15-20° in adults. The tibia "derotates" outward. - **Final result:** Adults have alignment that allows feet to point slightly outward (10-15°) during walking. **When torsions are excessive:** If femoral anteversion remains high (persistent anteversion), the child will walk with feet turned inward. If it's reduced (retroversion), they'll walk with feet turned outward. The same applies to the tibia. **How they're measured:** The orthopaedist performs specific clinical maneuvers to assess the degree of internal and external rotation of hip and tibia. X-rays or CT scans are rarely needed. **Treatment:** In the vast majority of cases, torsions normalize spontaneously with growth. Braces and special shoes haven't proven effective. Surgery (derotational osteotomy) is reserved for rare cases of severe, symptomatic deformity persisting after skeletal maturity.