De-rotation Osteotomies

In-toeing in children can be a result of many different causes. Most commonly it occurs as a result of the femur (thigh bone) developing along the higher end of the normal rotational profile spectrum (increased anteversion of the femur). In the majority of cases this improves without any intervention as the child grows. In some cases where the condition persists towards early adolescence and is causing persistent trips and falls in the child, surgery may be required to correct this abnormal rotational development of the thigh bone.

Surgery involves an osteotomy (controlled fracture/break) and realignment (de-rotation) to correct the in-toeing from excessive femoral anteversion. The osteotomy is then stabilised with either a plate and screws on the surface of the bone, or a rod inserted inside the bone.

Most cases of in-toeing improve naturally and will not require surgery. Your surgeon will discuss de-rotation osteotomy of the femur if suitable in your child after assessment of his or her limb and understanding how the in-toeing is affecting their function.