Femoral Anteversion


What is femoral anteversion?

Femoral anteversion is an inward twisting of the thigh bone (femur). Femoral anteversion causes a child's knees and feet to turn inward and have a "pigeon-toed" appearance. This is also called in-toeing.

Femoral anteversion occurs in up to 10 percent of children. The condition is somewhat more common in girls than boys. It often, but not always, affects both legs.

Most children don't need treatment for femoral anteversion — the condition usually resolves on its own. For kids who need surgery for a severe form of the condition, the outlook is excellent. The surgeries are quite safe.

Femoral anteversion typically does not lead to arthritis or any other future health problems.

What are the symptoms of femoral anteversion?

In toddlers and young children with developing hips, walking with pigeon-toes is normal. Even when caused by femoral anteversion, inward-pointing toes usually straighten out on their own as children learn to walk.

Signs of femoral anteversion usually first become noticeable when a child is between 2 to 4 years old, a time when inward rotation from the hip tends to increase. The condition becomes most obvious when a child is 5 to 6 years old.

If your child has any of the following symptoms of femoral anteversion, it’s a good idea to talk with their doctor:

  • pigeon-toed walking
  • inability to walk with their feet close together and legs straight
  • running with their legs swinging out
  • tripping and falling often

What causes femoral anteversion?

Femoral anteversion is usually considered to be a variation of normal development. Doctors don’t know what causes it or why some children develop severe femoral anteversion.

How serious is femoral anteversion?

For the vast majority of children, femoral anteversion is a minor condition that self-corrects by adolescence. Very few cases are painful or severe enough to require surgery.

Boston Children's approach to femoral anteversion

Boston Children's Hospital is a world leader in pediatric orthopedics. Our Orthopedic Center has vast experience treating children with every kind of orthopedic condition, some of which few other pediatric hospitals have ever encountered. Our experts in the Child and Adult Hip Preservation Program provide diagnosis, treatment, and care for every level of complexity and severity of femoral anteversion.