Rotational Variations of the Lower Extremity in Children

Abstract

Variations of the rotational profile of the lower extremities are so common in healthy children that most torsional deviations involving the legs and feet should be viewed as variations of normal rotation rather than as true pathologies. Parents are primarily concerned about the possibility of their child having a permanent disability in adulthood as a result of such variations, and secondarily concerned that these variations may hinder the child's athletic activities that involve running. In this article, we review the etiology and pathophysiology of some commonly seen variations in the rotational profile of the lower extremities of children, discuss their natural histories, outline several potentially serious causes of rotational abnormality identified by physical examination, provide guidelines for radiologic imaging of the lower extremities in such situations, and discuss considerations for the management of these situations with the goal of helping the clinician to better formulate an appropriate plan of care for the children they affect and to better educate these children's families and referring care providers.

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