What is Femoral Retroversion?
The femur or thighbone is the long bone present in your legs. It connects the hip and the knee joint. Femoral retroversion also called hip retroversion, is a rotational deformity of the lower limbs characterized by excessive outward (backward) bending of the femur in relation to the knee. This results in twisted legs and/or knees. Femoral retroversion can be seen in children and adults and can occur in one or both legs.
What are the Causes of Femoral Retroversion?
The exact cause of femoral retroversion is not clear. However, it may occur due to:
- A genetic mutation
- A deviation from the normal head-down position of the fetus in the uterus such as breech or transverse position
- Abnormal development of the baby in the womb
- Childhood trauma or fracture
What are the Signs and Symptoms of Femoral Retroversion?
Femoral retroversion may not be significant after the birth of your baby or in the initial years of their development. However, as the baby continues to grow, the twisted legs may either straighten or continue to bend. In the case of the latter, you will need to consult a bone and joint specialist or an orthopedic doctor to obtain timely treatment.
Some of the common signs and symptoms may include:
- Abnormal gait (walking style)
- Out-toeing or duck walk: each foot points outwards
- Flatfeet
- Tripping during walking or running activities
- Pain in the hips and/or knees
How is Femoral Retroversion Diagnosed?
You should consult an orthopedic surgeon specializing in knee and hip disorders. The doctor will review your child’s medical history, family history, and check for external symptoms such as bone deformity, abnormal gait, and out-toeing. In addition, strength of the muscles in the lower limbs and range of motion will also be checked. Imaging tests such as X-ray, MRI (magnetic resonance imaging) or a CT (contrast tomography) scan may also be recommended to confirm the diagnosis and develop a treatment plan best suited for your child.
What are the Treatment Options for Femoral Retroversion?
Your child’ doctor can treat femoral retroversion through a range of options. The first choice of treatment is usually the conservative approach. It is only after the condition doesn’t resolve on its own or failure of non-surgical methods, that the doctor will suggest surgery.
Non-Surgical Treatments
- Oral medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to suppress pain and inflammation
- Orthotic devices such as insoles, knee braces, and crutches to provide walking support
- Physical therapy in the form of massage and exercises
- Pain relief injections into the affected joint to suppress the pain and inflammation
- Immobilization by a cast or splint to allow the affected leg to rest
Surgical Treatment
Surgery is recommended for severe femoral retroversion and those cases which fail to heal despite conservative therapy. The surgical procedure for the treatment of femoral retroversion is called femoral osteotomy.
Femoral Osteotomy
Femoral osteotomy aims to correct rotational deformities in the femur and out-toeing while walking. In general, the procedure involves the following steps:
- A general or regional anesthesia is administered to the patient.
- Your surgeon makes a surgical incision on the outside of the thigh area to visualize the head of the femur (bony ball).
- The thigh bone is cut and the head of the femur in the hip socket is repositioned to attain a perfect angle.
- In some cases, the socket is also suitably trimmed to facilitate a better fit for the femoral head inside the socket.
- When the desired position is achieved, metal plates and screws are placed to hold the bone in this new position, until it is completely healed.
- These plates and screws may need to be taken out once complete healing is accomplished in a year or two.
- The surgical incisions are closed in layers and a sterile dressing is applied.
