Torsional Profile
Torsional deformities become much more apparent with fatigue.
Foot Progression Angle
Image 9
The foot progression angle is also know as the gait angle. It is the angle made by the foot with respect to a straight line that is plotted in the direction the child is walking.
To assess the foot progression angle:
To assess the foot progression angle:
- Dust the child’s feet with chalk (or use paint) prior to having the child walk on the paper toward his or her parent(s)
- a plus sign indicates an out-toeing
- a minus sign indicates an in-toeing
(11, 13)
Thigh Foot Angle
Image 10
- The thigh foot angle is the angle between the axis of the foot and the axis of the thigh
- This should be measured with the child in prone and knees flexed to 90 degrees
- In-toeing angles are given negative values while out-toeing angles are given positive values and this angle described the degree of tibial torsion
- Both legs should be measured as the problem may be due to unilateral tibial torsion or a difference in tibial torsion between the two legs
- The normal foot axis out-toes approximately 10 degrees relative to the thigh axis
- If the toe turns in relative to the thigh axis then it is considered an internal tibial torsion
- Birth: -30 to +20
- Age 3: -10 to +20
- Mid childhood to skeletal maturity: -5 to +30
(11, 13)
Rotation of the Hip (Internal and External)
Image 11
Hip internal and external rotation should be measured with the child in prone and the knees flexed to 90 degrees
- Hip Internal Rotation is determined by fully abducting the legs (one at a time)
- Hip External Rotation is determined by fully adducting the legs (one at a time)
(11, 13)
Forefoot Alignment
Image 12
Metatarsus adductus is present if the sole of the foot
is adducted (deviates medially) and if the lateral aspect
of the foot is "C" shaped.
is adducted (deviates medially) and if the lateral aspect
of the foot is "C" shaped.
(11)
