Year: 2025 | Month: September | Volume: 12 | Issue: 9 | Pages: 12-18
DOI: https://doi.org/10.52403/ijrr.20250903
Torsional Deformity: A Review Article
Pande Putu Agung Willa Kesawa Putra1, Made Agus Maharjana2
1Resident of Orthopedic and Traumatology Department, Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
2Consultant of Orthopaedic and Traumatology Department, Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
Corresponding Author: Pande Putu Agung Willa Kesawa Putra
ABSTRACT
Rotational variations of the lower extremities, including in-toeing and out-toeing, are common in children and usually represent normal developmental differences rather than pathological conditions. In-toeing is most frequently caused by metatarsus adductus in infants, internal tibial torsion in toddlers, and persistent femoral anteversion in older children, while out-toeing may result from femoral retroversion, external tibial torsion, severe pronation, or torsional malalignment. Diagnosis relies on history and physical examination, including assessment of Foot-Progression Angle (FPA), hip rotation, tibial torsion, and the transmalleolar axis, with imaging reserved for atypical or severe cases. Management is predominantly non-surgical, focusing on observation and physiotherapy, with most children improving spontaneously over time. Surgical intervention, such as rotational osteotomy, is indicated in absolute cases with severe functional or cosmetic impairment. Understanding the natural history, diagnostic evaluation, and treatment options is essential for guiding clinical management and counseling families.
Keywords: Torsional Deformity, In-toeing, Out-toeing
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