Femoral anteversion causes inward twisting of the thigh bones, leading to a pigeon-toe gait. It is usually congenital and can be diagnosed by a GP or through tests. Treatment is unnecessary if the anteversion is between 40 and 50 degrees, but if it is more than 50 degrees and the child is eight years or older, surgery may be necessary. Femoral derotation osteotomy is a common surgical treatment that involves cutting into the femur, rotating the ball of the femur, and reattaching the bone. Recovery can take three to six months.
Femoral anteversion is a condition in which the thigh bones of the thighs twist inward more than usual, causing an individual’s knees and feet to twist inward. People with this type of femur anteversion have an unusual gait, as they are unable to walk with their legs straight and feet close together. This style of walking is often referred to as “pigeon toe” or “tiptoe”.
Femoral anteversion in children is usually congenital, which means that the child is born with the condition. Up to ten percent of babies are born with anteversion of the femur, and girls are twice as likely to be affected as boys. This condition does not increase your child’s risk of developing conditions such as arthritis or other muscle or bone diseases.
The exact cause of femur anteversion is unknown. It is thought to be related to the position of the baby in the uterus, as some positions can cause the hip muscles and femur bones to be in an abnormal position. The condition may also be partially genetically inherited, as there is a tendency for the pigeon-toe gait and appearance to run in families.
Femoral anteversion can be diagnosed by a GP during a physical exam. In some cases, tests such as an X-ray, CT scan, or MRI may be used to aid in the diagnosis. These tests are used to assess the child’s degree of anteversion to determine what type of treatment may be needed.
At birth, the femur bones are normally about 40 degrees anteverted. By adolescence, this reduced to between 10 and 15 degrees. In a child with femoral anteversion, the femurs are more than 40 degrees anteverted and, in some cases, more than 50 degrees. When anteversion is between 40 and 50 degrees, treatment is often unnecessary because anteversion will have decreased significantly by the time the child enters adolescence.
If the anteversion is more than 50 degrees and the child is eight years old or older, some type of surgical treatment may be performed. This is because at this age and with this degree of anteversion, the condition is unlikely to have corrected itself by the time it reaches adolescence. The commonly used surgical treatment of femoral anteversion is called femoral derotation osteotomy.
During a femoral derotation osteotomy, an orthopedic surgeon will cut into the femur, rotate the ball of the femur in the hip socket until it sits normally, then reattach the bone. Metal plates can be attached to provide support and stability for bones as they heal. This procedure is performed under general anesthesia and will normally require a few days of hospitalization afterwards. Healing can take three to six months, and most children require pain medication and physical therapy to aid in recovery.
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