Tibial torsion

Meyer EG, Haut RC (2008) Anterior cruciate ligament injury induced by internal tibial torsion or tibiofemoral compression. J Biomech 41(16) 3377-3383... 

Unilateral structural changes short leg or unilateral flat foot or pronation tibial torsion, knee deformity, or hip deformity sacral torsion or pelvic torsion... 

Pediatric musculoskeletal problems should be evaluated and treatment instituted before the onset of weight-bearing. Equinus, calcaneus valgus, pronation, flatfoot, tibial torsion, metatarsal varus, clubfoot, and congenital dislocation of the hips should all be diagnosed and treated properly before the child begins to walk. 

Tibial torsion is a condition in which the tibia is twisted on its iongitudinai axis, usually internally, and the relationship between the patella and the foot is abnormal. It can be secondary to a femoral torsion. The torsion creates a toeing-in of both feet In the infant, the parents can stretch the muscles of the feet and legs daily. Osteopathic manipulation, especially fascial release, is useful in this condition. 

FIGURE 47.9 Comparison of relaxation spectra for wet human bone, specimens 5 and 6 [Lakes et al., 1979] in simple torsion T = 37°C. First approximation from relaxation and dynamic data. Human tibial bone, specimen 6. A Human tibial bone, specimen 5, Gstj = G (10 sec). Gsta(5) = G (10 sec). Gstd(5) = 0.590 x 10 Ib/in. Qtd(6) X 0.602 X 10 Ib/in. (Courtesy Journal ofBiomechania, Pergamon Press.)... 

Ankle fractures account for approximately 5.5% (Landin 1983) of paediatric fractures and the distal tibial and fibular physes are common sites of physeal injury (Peterson and Peterson 1972). The potential consequences of ankle and distal tibial physeal injury are leg length inequality, angular and torsional malalignment and post-traumatic arthritis. 

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