Disorders of the Leg (Pediatric)

  • Introduction

  • Intoeing is common in young children. It can be the result of a misshapened foot (metatarsus adductus) or too much internal rotation of the leg bone (internal tibial torsion) or of the thigh bone (femoral anteversion). A clinical examination will easily determine the source of the intoeing. Treatment is infrequently needed as the condition tends to spontaneously improve.
  • Knock-knees/Bowleggedness: Infants usually start out with their legs bowed however it typically improves by the age of 2. If it does not, an X-ray will be necessary to check the development of the growth plates (looking for a condition called Blount's disease). Young children frequently become maximally knock-kneed by the age of 3 or 4. This gradually improves to the age of 7, at which point, the adult pattern of mild knock knees remains.
  • Limb Length Discrepancy (LLD), if significant, can cause problems with walking and/or pain syndromes. However, most lower extremity LLD are mild (<2cm) and cause no functional impairment. X-rays can measure the amount of LLD.
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