External Tibial Torsion

Epidemiology

 

Presents in late childhood

 

Often unilateral

 

More often right side

 

NHx

 

Tends to increase with age

- rarely a problem until late childhood

- associated with PF instability & pain

 

Aetiology

 

Spina bifida / CP

 

Torsional Malalignment Syndrome

 

Miserable Malalignment Syndrome

- IFT with compensatory ETT

 

Management

 

Non-operative Management

 

Useless

- rarely indicated on functional grounds

- lever action of foot is not lost until the FPA > 60°

 

Operative Management

 

Indications

- osteotomy indicated if TFA > 40°

- certain cases of CTEV & NMD