- medial femoral torsion; femurs are 'rolled' medially.
- internally rotated hip makes child sits in reverse tailor position: knees
pointing forward, lower legs splayed back; presents at 4-5 years of age)
- Log Roll test: with child supine lying flat (hips and knees in extension),
grip the knee and rotate the femurs to-and-fro
- The normal exam should allow approximately 45 degrees of internal and
- With femoral anteversion, the femur can usually be internally rotated up
to 90 degrees, but the degree of external rotation is limited.
- With child prone, the knees flexed to a right angle and the pelvis level,
check amount of internal and external rotation. Internal rotation of more than
70 degrees from vertical is abnormal.
- discourage sitting in the TV squat position ("W" position)
- encourage to sit Indian-style with the legs crossed over each other.
- If very severe or severely affecting gait, may require orthopedic
treatment which ranges from night splinting to derotation osteotomies
CHLA Board Review 2005