We studied 1,000 normal lower extremities of children and adults in
order to establish normal values for the rotational profile. The
intrauterine position of the fetus molds the femur by rotating it laterally
and molds the tibia by rotating it medially. These molding effects usually
resolve spontaneously during infancy, and then genetically determined
individual differences are unmasked. Rotational problems should be
clinically evaluated and the findings compared with the normal values
provided by this study. Out-toeing in infants, medial tibial torsion in
toddlers, and medial femoral torsion in young children are extremes of a
normal developmental pattern. In the vast majority, these rotational
variations fall within the broad range of normal and require no
treatment.