In-toeing and out-toeing gait conservative treatment; hip anteversion and retroversion: 10-year follow-up

Abstract

Background: In-toeing and out-toeing rotational deformities are among the most common referrals for consultation with orthopedic specialists. Although a few number of patients need surgical interventions, most of them get better spontaneously
without major complications in adult life. In this study, we investigated the prevalence of permanent gait deformities due to hip rotational disorders in a group of patients who underwent conservative treatments. Patients and Methods: This retrospective cohort study was conducted in the orthopedic department on patients with rotational deformities of the lower extremities (hip anteversion and hip retroversion). From 2,983 patients, 611 were included in this study and followed up for 10 years. Medial rotation of the hip, lateral rotation of the hip, and tibia fibula angle (TFA) of each patient were measured independently. Results: In this study,611 patients were assessed and 323 (143 male and 180 female) were followed up in our study. Two hundred and seventy patients had in-toeing gait disorders due to hip anteversion, which 178 of them were corrected conservatively (%). Furthermore, among 53 patients with out-toed gait due to hip retroversion, 44 patients (%) were corrected in the same conditions (P = 0.001). It was determined that gait disorders were corrected conservatively in 102 of 143 males and 120 of 180 females (P = 0.37). Conclusion:Our findings showed that rotational deformities are expected to be corrected by conservative management. It is better to consider
surgical procedures as the last therapeutic option.

Key words: Hip anteversion, hip retroversion, in-toeing gait, out-toeing gait, tibia fibula angle (TFA)