The normal development of tibial torsion

Objective: Pathological rotation of the leg is a well-known problem in paed iatric orthopaedics. In this study the normal development of tibial torsion during growth was evaluated by computed tomography (CT). Design: Seventy-e ight normal individuals (52 children, 26 adults) aged 3-51 years were exami ned with CT. In axial scans the angle between a line tangential to the post erior part of the femoral condyles and the intermalleolar line, a line thro ugh the centre of the lateral and medial malleolus, was measured. The radia tion exposure was evaluated and accepted by The National Department for Rad iation and the Regional Committee for Ethics in Science. Results: CT showed that the average lateral torsion of the leg at the age of 4 years was 28 d egrees with an individual variation of 20 degrees -37 degrees. Later the in crease in tibial torsion was on average 1 degrees /year until 10 years of a ge and, thereafter, 4 degrees until maturity when the mean lateral torsion was 38 degrees (18 degrees -47 degrees). Conclusion: Tibial torsion in chil dren mainly develops during the first 4 years of life. After this the incre ase was of less clinical significance.