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Femoral Anteversion

more about Femoral Anteversion


  • In this condition, the femur (thighbone) is rotated slightly toward the midline of the body, where the belt buckle would be.  This change makes the entire lower extremity on the affected side rotate inward.  Often it occurs in both the right and left thighbone.
  • Lower extremity is a term meaning the entire unit of thigh, lower leg, and foot, on one side of the body.
  • If one casually looks at the feet, it appears that the problem is a rotation at the level of the feet, but actually this problem originates in the thigh area.
  • The footprints, with the entire foot turned inward, resemble those of a pigeon, and thus the description, "pigeon-toed."
  • When he or she learns to walk, the child usually will continue the in-toeing of the gait (all the movements that go into walking) in the first few years.  By kindergarten age, this generally has corrected itself, and the child may actually walk with "out-toeing" then.

  • There is no pain, but the position of the feet may cause a child to strike one foot against the other, and fall.  The appearance of the gait may be quite noticeable, causing people to comment.

  • The fetus may have a muscle imbalance in which the muscles responsible for twisting the hip inward pull more forcefully than the muscles twisting the hip outward.  This continues to be the case after the child is born.
  • The fetus may have the neck of the femur (the first part of the femur) join the main shaft of the femur at an abnormal angle, causing the main shaft of the femur to rotate inward.

  • On examination, the walking child is seen to have in-toeing of one or both feet.  Further, it is seen that the feet are actually straight in line with the lower leg, and that the gait results from the position of the hips and femurs.
  • By gently rotating the femur in the inward direction and the outward direction, the physician can see if there is much more "play" than normal in the inward direction (and conversely much less "play" in the outward direction).
  • If other family members walk in the same manner, this is additional evidence of femoral anteversion, since it may be familial.
  • It is possible on X-rays or CAT scan (a 3-D X-ray) or MRI scan (a 3-D imaging using magnets instead of X-rays) to view the entire area of the hip, to see whether the thighbone is anchored at the proper angle, or whether the thighbone is rotated inward.  Also, one can measure the angle where the neck of the femur meets the main shaft.

  • Sometimes, this is familial

  • Over time, the condition corrects itself in almost all cases, before the teenage years.  In rare circumstances, there is little improvement, and braces or orthopedic shoes are used.

  • In rare cases, the condition persists.  As compensation, the tibia (the main bone in the lower leg) may curve outward.  Since this compensating change, by itself, would make the child have toe-out, the two conditions together (femoral anteversion and tibial torsion) may very well make the feet point straight ahead.

  • The child's unclothed examination should be done, specifically to see if the lower extremities (including the feet) point properly in the forward direction.  A physician will be able to tell whether the abnormal pointing of a lower extremity is due to femoral anteversion.

  • Not referring to other conditions of the femur, but only to "toeing-in" (since this is what families notice), there are three conditions that replicate this phenomenon:
    1. Femoral anteversion
    2. Tibial torsion (usually a minor amount of curve in the tibia, which is the main bone in the lower leg)
    3. Metatarsus Adductus (a rotation inward of the front part of the foot, which anchors the toes)




more about Femoral Anteversion


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