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Femoral Anteversion in Children: Causes, Symptoms and Treatment
Femoral Anteversion in Children: Causes, Symptoms and Treatment

The femur, also called the thighbone, is the longest, heaviest, and strongest bone in your body. Its topmost part, known as the femoral head, forms a ball-and-socket joint with your hip, and this unique structure helps bear your weight and allows you to stand and move without any problems.

So when the thighbone is rotated or twisted inwardly, the toes may turn inward and the legs may look bowed. This condition is called femoral anteversion.  

What is Femoral Anteversion? 

Femoral anteversion is a disorder wherein the femoral neck (the part of the femur running from the hip to the knee) is excessively twisted or turned toward the body’s midline. This consequently results in the in-turning of the knees and feet, which becomes noticeable in children ages 4 to 6 years old.

Femoral Anteversion in Children

Children are typically born with 30 to 40 degrees of femoral anteversion. Fortunately, this decreases to 10 to 15 degrees as they grow and their bones mature. Moreover, most children won’t need serious treatments or surgeries to resolve the misalignment as it usually corrects itself over time.

Femoral anteversion is also a minor condition, so it rarely causes pain or other health complications. However, it may bring about symptoms that can affect a child’s gait (manner of walking) and interfere with their ability to take part in different activities.

Aside from that, there are cases of excessive anteversion wherein the malalignment of the femoral neck puts extra strain on the front structures of the hip joint. Without prompt femoral anteversion treatment, this may eventually lead to pain in the hip and knee joints and abnormal wear and tear.

What Causes Femoral Anteversion in Children?

While its exact cause is still unknown, femoral anteversion is a common congenital condition that can arise as a fetus develops in the womb. It could be that the baby’s position inside the uterus put excess strain on the hips, causing the torsional malalignment.

Since femoral anteversion tends to run in families, genetic factors can cause this condition too. Other than that, this deformity can also develop after a traumatic event as well. 

Symptoms of Femoral Anteversion 

These are the most common symptoms of femoral anteversion in children:

  • Pigeon-toed walking
  • Bowed legs
  • Inability to walk with their feet close together and legs straight
  • Pain in the hips, knees or ankles
  • Running with legs swinging out
  • Tripping and falling often 

These signs and symptoms usually present themselves in children ages 2 to 4 years old since this is when the in-turning from the hip tends to increase. While the condition rarely causes pain, children with this femoral anteversion start to struggle to walk and run properly at this time. The deformity ultimately becomes more pronounced when a child is 5 to 6 years old but resolves itself by the age of 8.

If the symptoms listed above persist after this age, it’s best to consult your child’s physician to determine if corrective surgery is necessary.

Femoral Anteversion Treatment

A doctor will first perform a physical examination to observe your child’s gait and look for signs of pigeon-toed walking. Your physician may also request diagnostic tests such as x-rays and CT scans to get detailed images of your child’s hip joint and thigh bone and diagnose the deformity better.

If the degree of rotation is within normal limits, no treatment is necessary. As mentioned earlier, femoral anteversion in children usually resolves on its own as they grow. By the time they are 8 to 10 years old, they are likely to walk normally.

However, surgery may be needed if the anteversion is excessive enough to impede walking or running. In a procedure called femoral derotation osteotomy, a surgeon cuts the femur, rotates the femoral head to a normal position, reattaches the thighbone, and holds it in place by inserting a rod.

Your child may have to stay in the hospital for a couple of days to manage the pain. Afterward, they might use crutches for about 4 to 6 weeks. And with physical therapy, they should be able to return to their activities within 3 to four months.

How to Fix Femoral Anteversion in Adults  

Children often recover well after a femoral derotation osteotomy because the surgery is safe and their bones tend to heal quickly. With that said, older people with hip pain and hip joint damage are worried about how to fix femoral anteversion in adults, especially if surgery is necessary.

While femoral derotation osteotomy is a significant procedure, hip arthroscopy makes it possible to perform it in a minimally invasive manner. An arthroscopic surgery only entails making small cuts around your hip, involving fairly minimal pain and allowing you to recover in around six weeks.

Let Us Help You Get the Most Appropriate Treatment for Your Femoral Anteversion

Whether you or your child is struggling with the persistent symptoms of femoral anteversion, know that this condition is treatable. As one of the most experienced hip arthroscopy surgeons globally, Dr. Benjamin Domb can diagnose your case and determine if you are a candidate for hip arthroscopy. But most importantly, the friendly medical staff at Dr. Domb’s office will provide you with the most caring treatment to relieve your pain and help you get back to enjoying your activities as soon as possible.

If you want to know more about our innovative minimally invasive joint surgeries, don’t hesitate to contact us today. We look forward to helping you!