Lower extremity abnormalities in XXXX .

@entity1 @entity66 @entity13809 @entity85 @entity2096
Rotational and angular problems are two types of @entity66 common in @entity1 . Rotational problems include intoeing and out-toeing. Intoeing is caused by one of three @entity85 : metatarsus adductus, internal tibial torsion, and @entity2096 . Out-toeing is less common than intoeing, and its causes are similar but opposite to those of intoeing. These include @entity2096 and external tibial torsion. Angular problems include @entity13809 . An accurate diagnosis can be made with careful history and physical examination, which includes torsional profile (a four-component composite of measurements of the lower extremities). Charts of normal values and values with two standard deviations for each component of the torsional profile are available. In most cases, the abnormality improves with time. A careful physical examination, explanation of the natural history, and serial measurements are usually reassuring to the parents. Treatment is usually conservative. Special shoes, cast, or braces are rarely beneficial and have no proven efficacy. Surgery is reserved for older @entity1 with deformity from three to four standard deviations from the normal.
