Femoral anteversion

Children’s Hospital Boston’s hip sub-specialists provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care.

Specific treatment for femoral anteversion is determined by your child’s doctor based on:

• her age, overall health and medical history
• the degree of her in-toeing

Doctors treat most children who have femoral anteversion with close observation over the course of several years, since the twisting-in of the thigh bone usually corrects by itself with time. As the child grows, she’ll achieve normal or near-normal walking patterns by about 8 to 10 years of age, or by the time she becomes a teen.

Braces, special shoes and exercises don’t usually speed up or help the body’s own mechanism for self-correcting femoral anteversion.

If surgery is needed

In a very few cases, the twisting-in may be severe and may not self-correct by the time a child is age 8 or 9. For children with severe, unresolved femoral anteversion at that age, doctors may perform surgery to reposition the femur at a more normal angle. In the procedure (called a femoral derotation osteotomy) the surgeon cuts the femur, rotates the ball of the femur in the hip socket to a normal position, and reattaches the bone.

After surgery

After surgery, your child will probably stay in the hospital for a couple of days, and be given pain medication. When she goes home, she’ll need to limit her weight-bearing activities, and she might use crutches or a walker for a few weeks. Physical therapy will help her restore her muscle strength. She’ll probably be able to resume full activities, including sports, after three or four months.

Long-term outlook

• Since femoral anteversion is self-correcting in up to 99 percent of cases, the long-term outlook is very positive for most children with the condition.
• For children who need surgery for severe forms of the condition, the outlook is also excellent. The surgery itself is quite safe, with the added bonus that children’s bones usually heal faster and more reliably than adults'.
• Femoral anteversion doesn’t typically lead to arthritis or any other future health problems.

Coping and support

At Children’s, we understand that a hospital visit can be difficult. So, we offer many amenities to make your child’s—and your own—hospital experience as pleasant as possible. Visit the Center for Families for all you need to know about:

• getting to Children’s
• accommodations
• navigating the hospital experience
• resources that are available for your family

In particular, we understand that you may have a lot of questions when your child is diagnosed with femoral anteversion. Will my child need surgery? How long will her recovery take? Will it affect her long term? Children’s can help you connect with extensive resources to help you and your family through this stressful time, including:

• patient education: From doctor’s appointments to treatment to follow-up, our nurses and physical therapists will be on hand to walk you through your child’s diagnosis, surgery and recovery. And once your child is home, we’ll help you coordinate and continue the care and support she received at Children’s.
• parent-to-parent: Want to talk with someone whose child has been treated for femoral anteversion? Our Orthopedic Center can often put you in touch with other families who’ve been through the same experience that you and your child are facing.
• faith-based support: If you’re in need of spiritual support, we’ll connect you with the Children’s chaplaincy. Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.
• social work: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child’s diagnosis, stresses relating to coping with illness and dealing with financial issues.