Adorable baby girl sleeping in co-sleeper crib attached to parents' bed. Little child having a day nap in cot. Sleep training concept. Infant kid in sunny nursery
A 3-year-old boy has intoeing and trips frequently while walking. He tends to sleep in a fetal position on his stomach. His hip internal rotation is 45° and external rotation is 45°. The thigh-foot angle is minus 20° (inwards) and the heel bisector line crosses at the 2nd toe. Which of the following is most likely the cause of his intoeing?
Femoral anteversion
Internal hip rotation greater than external rotation or a palpated greater trochanteric angle of >15° would indicate this.
Internal tibial torsion
The thigh-foot angle confirms the deformity to be in the tibia. A bimalleolar axis would also confirm this.
Metatarsus adductus
The heel bisector going through the lesser rays lateral to the 2nd toe would indicate this.
External tibial torsion
A positive thigh-foot angle or bimalleolar angle of >15° or 25°, respectively, would indicate this.
