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"In-toeing"

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"In-toeing"

Original Articles

Pediatric rehabilitation

Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: 3-Year Follow-Up Study
Yeongchae Park, Hayoung Byun, Mi-Ji Kim, Heesuk Shin
Ann Rehabil Med 2023;47(3):182-191.   Published online June 21, 2023
DOI: https://doi.org/10.5535/arm.23043
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

Citations to this article as recorded by  
  • 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
  • 8,063 View
  • 143 Download
  • 4 Web of Science
  • 5 Crossref
Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: One-Year Follow-Up Study
Minsik Kong, Hongsik Jo, Chang Han Lee, Se-Woong Chun, Chulho Yoon, Heesuk Shin
Ann Rehabil Med 2018;42(1):137-144.   Published online February 28, 2018
DOI: https://doi.org/10.5535/arm.2018.42.1.137
Objective

To evaluate femoral anteversion angle (FAA) change in children with intoeing gait depending on age, gender, and initial FAA using three-dimensional computed tomography (3D-CT).

Methods

The 3D-CT data acquired between 2006 and 2016 were retrospectively reviewed. Children 4 to 10 years of age with symptomatic intoeing gait with follow-up interval of at least 1 year without active treatment were enrolled. Subjects were divided into three groups based on age: group 1 (≥4 and <6 years), group 2 (≥6 and <8 years), and group 3 (≥8 and <10 years). Initial and follow-up FAAs were measured using 3D-CT. Mean changes in FAAs were calculated and compared.

Results

A total of 200 lower limbs of 100 children (48 males and 52 females, mean age of 6.1±1.6 years) were included. The mean follow-up period was 18.0±5.4 months. Average initial and follow-up FAA in children with intoeing gait was 31.1°±7.8° and 28.9°±8.2°, respectively. The initial FAA of group 1 was largest (33.5°±7.7°). Follow-up FAA of group 1 was significantly reduced to 28.7°±9.2° (p=0.000). FAA changes in groups 1, 2, and 3 were −6.5°±5.8°, −6.4°±5.1°, and −5.3°±4.0°, respectively. These changes of FAA were not significantly (p=0.355) different among the three age groups. However, FAA changes were higher (p=0.012) in females than those in males. In addition, FAA changes showed difference depending on initial FAA. When initial FAA was smaller than 30°, mean FAA change was −5.6°±4.9°. When initial FAA was more than 30°, mean FAA change was −6.8°±5.4° (p=0.019).

Conclusion

FAA initial in children with intoeing gait was the greatest in age group 1 (4–6 years). This group also showed significant FAA decrease at follow-up. FAA changes were greater when the child was a female, younger, and had greater initial FAA.

Citations

Citations to this article as recorded by  
  • 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
  • Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: 3-Year Follow-Up Study
    Yeongchae Park, Hayoung Byun, Mi-Ji Kim, Heesuk Shin
    Annals of Rehabilitation Medicine.2023; 47(3): 182.     CrossRef
  • Pediatric orthopedic mythbusters: the truth about flexible flatfeet, tibial and femoral torsion, W-sitting, and idiopathic toe-walking
    Evan L. Honig, Heather S. Haeberle, Clare M. Kehoe, Emily R. Dodwell
    Current Opinion in Pediatrics.2021; 33(1): 105.     CrossRef
  • Age-related decrease in supratrochanteric torsion and increase in infratrochanteric torsion in healthy pediatric femurs: an MRI study
    Yakup Alpay, Osman Nuri Ozyalvac, Emre Turgut, Evren Akpinar, Abdulhamit Misir, Avni Ilhan Bayhan
    Journal of Pediatric Orthopaedics B.2021; 30(4): 324.     CrossRef
  • Unilateral premature osteoarthritis of the hip with excessive anteversion of the femoral neck developing in the early second decade: two surgical cases
    Takahiro Nishimura, Hideaki Watanabe, Naoya Taki, Saki Onuma, Ichiro Kikkawa
    BMC Musculoskeletal Disorders.2021;[Epub]     CrossRef
  • Assessment of anxiety and depression levels in parents of children presenting to the orthopedics outpatient clinic with the complaint of in-toeing
    Bahtiyar HABERAL, Ebru ALTINTAŞ, Salih BEYAZ
    Journal of Surgery and Medicine.2020; 4(11): 1.     CrossRef
  • 8,757 View
  • 147 Download
  • 7 Web of Science
  • 6 Crossref
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