Objective
To investigate long-term changes in femoral anteversion angle (FAA) in children with intoeing gait and to identify factors that affect FAA changes.
Methods
We retrospectively analyzed three-dimensional computed tomography data from 2006 to 2022 of children with intoeing gait with ≥3 years of follow-up without active treatment. The study examined the mean changes in FAA, the effects of sex, age, and initial FAA on FAA change, and mean FAAs by age. Changes in FAA severity up to eight years of age were also observed and analyzed by sex.
Results
A total of 126 lower limbs of 63 children (30 males, 33 females) with intoeing gait were included, with a mean age of 5.11±1.05 years and a mean follow-up period of 43.59±7.74 months. The initial FAA was 41.42°±8.29° and the follow-up FAA was 33.25°±9.19°, indicating a significant decrease (p<0.001). Significant correlations were observed between age and changes in FAA, as well as between initial FAA and changes in FAA (r=0.248, p=0.005; r=-0.333, p<0.001). At age 8 years, only 22 limbs were classified as having mild FAA severity.
Conclusion
During the follow-up period, children with intoeing gait had a significant decreased in FAA. No significant difference in FAA change was found between sex, but younger children and those with greater initial FAA were more likely to have decreased FAA. However, most children retained moderate to severe severity of increased FAA. Further studies are required to validate these findings.

Citations

• Assessments and interventions in individuals with lower extremity torsional abnormality: A scoping review
  M. Gagnon, N. Abdel Fattah, L. Groszman, N. Kabbes, M. Bernstein, L.N. Veilleux
  Journal of Orthopaedics.2026; 73: 247.     CrossRef
• Intra- and interobserver reliability of femoral torsion measurement using ultrasound with inertial sensor in children aged 7–9 years
  Xavier Ruiz-Tarrazo, Andrea Coda, Carla Sánchez-Dueñas, Salomé Tárrega, Carles Escalona-Marfil
  Gait & Posture.2026; 124: 110046.     CrossRef
• Effects of proprioceptive stimulation foot pads on in-toeing gait in children: a retrospective study
  Yulong Ben, Jing Chen, Danfeng Zheng, Ying Chen, Pengfei Zheng
  Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
• Establishing normative femoral morphology in the pediatric population using computed tomography
  Büşra Demirci, Yalçin Turhan, Niyazi Erdem Yaşar, Hilmi Alkan, Başak Sinem Sezgin, Avni Merter Keçeli, Ezgi Yağiz Ertuna, Sevinç Püren Yücel, Şenol Bekmez
  Journal of Pediatric Orthopaedics B.2026;[Epub]     CrossRef
• Exertional Compartment Syndrome in a Volleyball Player with Structural Abnormalities: A Case Report
  Katherine Wilson, Michael Oca, Leo L.T. Meller, Matthew R. Allen, Michael B. Strauss
  Current Sports Medicine Reports.2024; 23(8): 280.     CrossRef