Internal tibial torsion is a condition that occurs when the tibia, the larger of the two bones in the lower leg (also known as the shin bone), twists inward. The main symptom of internal tibial torsion is intoeing, where the feet angle toward each other when a child walks or stands. While this condition may not be noticeable until your child begins to walk, it is often present from birth. Internal tibial torsion commonly affects both legs and is believed to be related to the position of the baby in the uterus. Internal tibial torsion typically doesn’t cause pain, but it may lead to increased frequency of trips and falls as the child’s gait is affected. Although the condition usually resolves on its own as the child grows, it may require medical attention if it persists or causes difficulty with walking.
To diagnose internal tibial torsion, a healthcare professional will perform a physical examination, carefully observing the child’s gait and foot alignment. They will also measure the legs to determine the extent of the inward twisting of the tibia. These assessments help confirm the diagnosis and rule out other conditions that may cause similar symptoms, ensuring an accurate evaluation and appropriate management plan.
Internal tibial torsion often improves on its own by the age of 4 without the need for treatment. Monitoring a child’s growth is key to ensuring the condition resolves naturally. Bracing, casting, and physical therapy are typically unnecessary. However, if the twisting of the tibia remains significant by ages 9 or 10, surgical intervention may be considered. The procedure used to correct this is called tibial derotational osteotomy. During this surgery, the tibia is carefully cut, rotated, and repositioned to achieve a straighter alignment. Following the surgery, the leg will be placed in a cast to support healing, and physical therapy may be recommended to help the child regain a normal walking pattern and strengthen the muscles surrounding the tibia.