Increased femoral anteversion: Causes, effects, and treatment

Written in association with: Mr Shobhit Verma
Published:
Edited by: Kate Forristal

Increased femoral anteversion, also referred to as excessive femoral torsion, is a condition characterised by the forward twisting of the thigh bone (femur) in relation to the hip joint. While commonly observed in young children, this developmental variation can impact the alignment of the hip, knee, and foot, resulting in functional and biomechanical changes. In his latest online article, Mr Shobhit Verma explores the causes, effects on gait and alignment, diagnosis, and management strategies for increased femoral anteversion.

Causes:

Increased femoral anteversion is often considered a developmental variation that occurs during the growth and development of the skeletal system, particularly in childhood. The exact cause remains unclear, but genetic factors and intrauterine positioning may contribute to its occurrence. Fortunately, this condition tends to improve naturally as children grow older.

 

Effects on gait and alignment:

The excessive internal rotation of the femur within the hip joint can significantly impact the alignment of the lower limbs. Individuals with increased femoral anteversion may exhibit a pigeon-toed gait, with an increased tendency for their toes to point inward. This altered alignment can lead to difficulties in walking or running with the feet pointing straight ahead, potentially resulting in tripping, balance issues, and increased stress on certain joints and structures.

 

Diagnosis:

Diagnosing increased femoral anteversion typically involves a thorough physical examination and an assessment of gait patterns. Medical professionals may conduct specific tests, such as measuring hip range of motion and observing resting and walking postures. While further imaging studies like X-rays or CT scans are generally not necessary, they may be ordered in certain cases to rule out other conditions.

 

Management and treatment:

In most cases, increased femoral anteversion does not require specific treatment, as it tends to improve naturally with growth. However, healthcare professionals, such as paediatricians or orthopaedic specialists, may recommend monitoring the condition. Physical therapy can be beneficial to enhance balance, gait patterns, and muscular strength and flexibility. Surgical intervention is rare but may be considered in cases of severe functional limitations or persistent pain into adolescence or adulthood.

 

Prognosis:

The long-term prognosis for individuals with increased femoral anteversion is generally positive. As children grow and develop, the anteversion often reduces gradually, leading to improved alignment and gait. With appropriate management and therapy, most individuals can experience improved function, reduced symptoms, and normal overall development.

 

Mr Shobhit Verma is an esteemed consultant paediatric orthopaedic surgeon. You can schedule an appointment with Mr Verma on his Top Doctors profile.

By Mr Shobhit Verma
Paediatric orthopaedics

Mr Shobhit Verma is a highly respected consultant paediatric orthopaedic surgeon based in London, Bedfordshire and Hertfordshire. He is renowned for his expertise in foot and ankle problems, paediatric hip and walking disorders. He additionally specialises in bowed legs, deformity and hip dysplasia.

Mr Verma qualified in medicine from Veer Narmad South Gujarat University, India in 1995 before completing a Master of surgery (MS) specialising in orthopaedics. He then went on to undertake a series of highly esteemed fellowships, including several accredited by the Royal Australasian College of Surgeons (RACS). In this period, he completed a paediatric and adult trauma and arthroplasty fellowship at Flinders University and Medical Centre in Adelaide and was also a senior clinical fellow in trauma surgery at The Alfred Hospital in Melbourne. In 2013, Mr Verma was appointed as a fellow of the European Board of Trauma and Orthopaedics and the following year, also achieved fellowship of the trauma and orthopaedics section of the Royal College of Surgeons of Edinburgh. He was additionally awarded a senior fellowship specialising in paediatric orthopaedics at Birmingham Women’s and Children’s NHS Foundation Trust. Since 2016, Mr Verma has served as a consultant paediatric orthopaedic surgeon at King’s College London, Bedfordshire Hospitals and London and Dunstable Hospital NHS Foundation Trusts, and is clinical lead in orthopaedic surgery at the latter. He sees patients in private practice at a number of locations in London, Bedfordshire and Hertfordshire; The Cobham Clinic, The Clementine Churchill Hospital, One Hatfield Hospital, The Bridges Clinic and Spire London East Hospital.

Mr Verma has extensive teaching experience and has regularly trained junior doctors and medical students in Australia, India and the UK throughout his career. He currently serves as an invited faculty member of various FRCS courses in London and frequently teaches medical trainees from University College London and King's College London.

Additional to his clinical and teaching responsibilities, Mr Verma remains actively involved in research and has acted as principal investigator in various studies. He has also produced a number of academic papers which appear in peer reviewed journals and regularly presents at key conferences. Mr Verma is a member of the European Paediatric Orthopaedic Society and the Indian Medical Association.

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