Causes of Intoeing Gait in Children With Cerebral Palsy

Musculoskeletal Complications of Neuromuscular Disease in Children

“…The most common contributors, either alone or in combination, were internal hip rotation in 55% and internal tibial torsion in 50%. Pes varus and metatarsus adductus also contributed [80]. Although experts have previously suggested that spasticity of hamstrings and adductors contribute substantially to an internally rotated gait, more recent evidence suggests that intoeing in children who have cerebral palsy is almost universally associated with osseous deformity rather than hypertonia [80][81][82].…”

“…Pes varus and metatarsus adductus also contributed [80]. Although experts have previously suggested that spasticity of hamstrings and adductors contribute substantially to an internally rotated gait, more recent evidence suggests that intoeing in children who have cerebral palsy is almost universally associated with osseous deformity rather than hypertonia [80][81][82]. The overall prevalence of excessive internal hip rotation in cerebral palsy is 27%, with prevalence higher in those who have diplegia than in those who have hemiplegia [81].…”

A Descriptive Study of Lower Limb Torsional Kinematic Profiles in Children With Spastic Diplegia

“…Numerous studies investigating rotational malalignment have been reported but studies are variable regarding CP type (data from hemiplegic, diplegic, and quadriplegic patients were analyzed collectively), are usually focused on specific lower limb levels, or take various kinematic plane deviations into considerations. [3][4][5][6][7] Given that transverse plane abnormalities are not always recognizable through physical examination (static evaluation), instrumented gait analysis is a prerequisite for proper functional evaluation. [8][9][10] Transverse plane kinematics provide reliable information to analyze the impact of torsional deviations on lower limb alignment and gait patterns.…”

Coronal Plane Knee Moments Improve After Correcting External Tibial Torsion in Patients With Cerebral Palsy

“…Aiona (&), K. Calligeros, R. Pierce Medical Staff Department, Shriners Hospitals for Children, Portland, 3101 SW Sam Jackson Park Road, Portland, OR 97239, USA e-mail: maiona@shrinenet.org with CP did not undergo the normal remodeling with growth. Although this common internal femoral rotational deformity can adversely affect gait during childhood [2,4,21], correction by femoral osteotomies can be successful [1,11,17,21,23,27].…”