Rotational Deformity, Part 1

Rotational Deformity, Part 1

This month’s blog focuses on rotational deformities and is one of a two part series on the condition. Fifty years ago, Dr. Hughston, one of the founding fathers of American Sports Medicine, imparted a vernacular term for rotational deformities of the lower extremity – “Miserable Malalignment.”

A rotational deformity in adults can often be difficult to diagnose. Before finding an orthopedic specialist who can identify this condition, some patients may, unfortunately, undergo years of ineffective treatments and physical limitations.

Rotational deformities can frequently occur in childhood, evidenced by the appearance of their toes either pointed in (in-toeing) or out (out-toeing), and if caused as a part of normal development generally corrects itself once the child is weight bearing – without long lasting impact to the musculoskeletal system.

If the deformity is caused by another problem, it may persist into adulthood and become increasingly more difficult to identify.

The rotation comes from a rotation of either the femur (upper leg bone) or the tibia (lower leg bone). The deformity generally affects both legs and can often be a combination of angular and rotational components.

The rotational component of combined deformities can be diagnosed by a careful physical examination, quantified and confirmed by a specially done CT or MRI scan.

The four types of rotational deformities include:

  • Internal Tibial Torsion (ITT)
  • External Tibial Torsion (ETT)
  • Internal Femoral Torsion (IFT)
  • External Femoral Torsion (EFT)

Treating Rotational Deformity

There are both surgical and nonsurgical treatments for rotational deformity. The right treatment for each patient will depend on the type and severity of their deformity, as well as previous treatments they may have undergone.

In Part 2, we’ll discuss some of the surgical treatments proving effective today in addressing rotational deformities.

(Malalignments can cause a number of problems in the interconnected musculoskeletal system – from the neck and back to the foot and ankle. Proper diagnosis and correction is key to overall well being.)

Read rotational deformity patient testimonial.