Causes / typical injury mechanism: Internal tibial torsion is typically caused by improper external rotation of the tibia during the early years of growth, which may be secondary to improper fetal positioning in utero.

Classic history and presentation:

• Parents often report that their child's legs are "turning in," which is noticed when the patient begins walking. Parents might describe toes that face inward while the patella is still facing forward.
• Typically, there is bilateral presentation of increased internal tibial torsion.
• This condition can present with bowlegging.
• Patients can have frequent falls.

Prevalence: This condition typically presents in children aged 1-3 years with a prevalence of up to 30% in children under the age of 6 years.

Pathophysiology: The exact etiology is unknown, but fetal positions in utero are thought to be contributory.