Advertisement - Hide this advert





Author Topic: New and confused about 12 yr old daughter with increased femoral anteversion  (Read 3177 times)

0 Members and 1 Guest are viewing this topic.

Offline Trixiea40

  • MICROgeek (<20 posts)
  • *
  • Posts: 1
  • Liked: 0
Hi Everyone,

I could use some help/guidance and I apologize ahead of time for not knowing much about any of this.

My daughter walks with her feet turned in. Particularly her right foot. In fact, when standing it was most comfortable for her to stand with that right foot almost completely turned in/sideways. Now she does not do that anymore, however her gait is very noticeable, still. I guess over the years it was assumed this would go away on it's own (as I've read in some literarture) but it has not. My daughter is rather tall, too, almost 5'10" and will be 13 in July, got her period right after turning 12, so I don't know if she will continue to grow or has any chance of growing out of this, still.

We went to a PT and they explained something about her flexibility being over-flexible in some areas/her legs bending in ways that most people's don't, but tight in other areas. I don't even remember how long we did that (6 weeks a couple times a week?) but that was 1 or 2 years ago and didn't really seem to do anything--she was supposed to do some exercises at home/I really had no idea what this was supposed to do/and she was too young/immature to follow up.

I again expressed my concerns to the pediatrician who referred us to an ortho. That appointment was where she gave us the diagnosis of Increased Femoral Anteversion. She gave me an internet print out, basically. Did an examination. Flat out told my daughter that trying to walk straight would do her no good (is this true?) and went into details about a very complicated and risky surgery. I was not happy with this appointment. The woman pretty much dismissed us, I got the feeling because my daughter was so big and "old."

She has no pain. She sometimes trips up on her feet. She plays basketball and does pretty well. I would like her to run to stay in shape, and she'll probably start trying that.

I guess I am looking for information and to know if there is 1. any hope of her growing out of it, still. 2. any truth to the fact that she can try to walk straight and train herself to do this. 3. Will more PT help and who should we be looking for? (can any of this be helped by strengthening corresponding muscles?)  4. Am I right in thinking this surgery is so drastic it is not for us/her in this situation?

I have to be honest. I don't want her looking strange to others. She actually has a bit of a learning disability and I feel like it sucks for her to have this on top of that. She is a beautiful girl. I only want the best for her and I don't want to make her feel bad. That is why I don't want to make too big a deal about this, unless we can and should continue to find people that can help her.

I really appreciate any comments. I'm very glad I found this forum.

Trixie

Offline smillie

  • SuperKNEEgeek
  • *****
  • Posts: 1438
  • Liked: 1
Have you done a search on this site yet? Type "femoral anteversion" in the search box up there and you'll see a list of posts where you can start reading. Start doing your research and also try to figure out who the specialists would be in this area. You probably want to go beyond the average OS and seek an opinion from someone who actually deals with this type of problem regularly and can give you a realistic idea as to whether it is a good idea to put her through surgery to correct this, whether now or later and can answer your questions about growth, etc. As a mom of kids around your daughter's age, I can understand your feelings about all of this. I hope you can get some good information here and can get in touch with the right OS who can give you the information you need.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline Kimberly 77

  • Forum Faithful
  • ****
  • Posts: 296
  • Liked: 1
I found some interesting stuff for you. Femoral anteversion, means that the femur developed at a abnormal rotation, which is why your daughter walked with her toes in.  It is a develomental abnormality, the position she was in in your uterus could have caused it. Most children are born with 40 degrees of femoral anteversion, during adolescence this drops to about 10 to 15 degrees. Therefore it generally improves with further growth. The surgery should only be done in very severe cases and in a older child. But, this usually corrects itself by early adolesence. Surgery is indicated if the anteversion is over 50 degrees and the child is atleast 8 years of age. The only surgical treatment is a femoral derotation osteotomy. What I would do as a parent is seek a 2nd opinion from a pediatric orthopeadic surgeon, you may have to travel to do that. But, there are some positive things in the article I read, most outgrow it during adolesence and your daughter is at that stage now, she could possibly get better. I guess a good place to start is finding out if her anteversion is 50 degrees or more. Good Luck to you and your daughter.
Right leg amputee.
Osteoarthritis in left knee.
Medial femoral condyle defect, arthoscopy 8-2-10
Grade 3 defects, patella, medial femoral condyle, tibia scoped1-12-2011
Physical theraphy and awaiting microfrature 2-1-12

Offline KatesMom

  • MICROgeek (<20 posts)
  • *
  • Posts: 2
  • Liked: 0
 Hi!  I'm new here.. but inregards to your post: I also have a daughter ( almost 14)

 Who has knee issues.. We've been through alot in the past year trying to figure out just

what exactly is wrong & what can we do about it.. still don't have all the answers!

 Here's Kate's story in a readers digest version.. Kate started having Knee pain on a daily basis, on & off for a year.  The pain would sometimes be like level 7 or 8. Kate started to ask me for a leg brace.
 She could still walk but complained of pain. Kate had always been a very active Teen, involved in Cheerleading & sports, She is pretty muscular, Tall, & thin. I figured she had a minor injury from Cheerleading & didn't pay much attention to it.. ( also @ the time didn't have Ins)

   about 8 months later we were @ the mall xmas shopping & Kate had to sit out, & cried to go home because of her L knee pain. By then we had ins. & I was very concerned, but still thought it was just a minor sports injury.
 I took K to her 1st Ortho who took xrays & came in the office with the " look of death"
 You know the look when they think you are very sick... so he started questioning me about
Childhood cancer in our Fam history.. ect.
 K was rushed off immediately with test after test... 2 Ortho's both told us.. it her x- rays revealed a " bone abnormality" that looked like OsteoSarcoma ( bone cancer).
 Although her blood test were fine, the test were not enough to prove one way or the other..
 Went to a 3rd Ortho.. who was also concerned of the Abnormal Xrays & sent us to Shands.
 While at Shands they told us they believed it was " Benign"..  Big sigh of relief!! They told us they did not want to biopsy it because it was in the bone it would require a complicated biopsy, & he was convinced it was benign, so we opt to just go back in 3 months to monitor her. He said her " abnormality" was from a " Cortical Desmoid" A phenomenon that sometimes occurs in Tall children, it mimicks Cancer on x-rays & doctors sometimes confuse the two. Cortical Desmoids usually do not cause pain though from everything I read.. but they said it was the muscles around the abnormality, & the problem would self correct as the child grows.

 Meanwhile.. he sent her to PT for 6 weeks because he said her pain was from the muscles being tugged from the bone lesion. Her first time the PT seemed to help. We went back in 3 months & x-rays revealed it was almost gone! K had little pain.. I thought it was over!

  A few months later while shopping K begins severe pain.. Now it is daily.
 Back to PT we go.. except now it's worse. After PT K's knees swell & she has worse pain that is daily & more intense.  Now both knees hurt. Back to the Orthopedic Ped. Specialist who did more physical test who now says that K has a Femoral Anteversion, along with extremely hyper mobile joints causing her knee to move to much when she walks or does certain movements.
 K has pain going upstairs, walking for long periods or long distances. She tries to play sports, & wants to, but she has alot of pain after.
 We've been though so much.. I just want solid answers. I don't know if this issue going to get worse. Will she need surgery? I really don't want to put her through surgery because I read it's very complcated & can have complications. At the same time, if she does not, how will this effect her quality of life, will it lead to other problems? K is now beginig Aqua Therapy as of last week..
   If anyone has a similar story or knowledge, experience w/ any of this please reach out!!

                      Thank u for reading this!! God bless! :-\

Offline KatesMom

  • MICROgeek (<20 posts)
  • *
  • Posts: 2
  • Liked: 0
Re: !4 yr. old w/ Cortical desmoid, Femoral Anteversion & hypermobile joints.
« Reply #4 on: November 05, 2012, 02:51:54 AM »
Hi!  I'm new here.. but inregards to your post: I also have a daughter ( almost 14)

 Who has knee issues.. We've been through alot in the past year trying to figure out just

what exactly is wrong & what can we do about it.. still don't have all the answers!

 Here's Kate's story in a readers digest version.. Kate started having Knee pain on a daily basis, on & off for a year.  The pain would sometimes be like level 7 or 8. Kate started to ask me for a leg brace.
 She could still walk but complained of pain. Kate had always been a very active Teen, involved in Cheerleading & sports, She is pretty muscular, Tall, & thin. I figured she had a minor injury from Cheerleading & didn't pay much attention to it.. ( also @ the time didn't have Ins)

   about 8 months later we were @ the mall xmas shopping & Kate had to sit out, & cried to go home because of her L knee pain. By then we had ins. & I was very concerned, but still thought it was just a minor sports injury.
 I took K to her 1st Ortho who took xrays & came in the office with the " look of death"
 You know the look when they think you are very sick... so he started questioning me about
Childhood cancer in our Fam history.. ect.
 K was rushed off immediately with test after test... 2 Ortho's both told us.. it her x- rays revealed a " bone abnormality" that looked like OsteoSarcoma ( bone cancer).
 Although her blood test were fine, the test were not enough to prove one way or the other..
 Went to a 3rd Ortho.. who was also concerned of the Abnormal Xrays & sent us to Shands.
 While at Shands they told us they believed it was " Benign"..  Big sigh of relief!! They told us they did not want to biopsy it because it was in the bone it would require a complicated biopsy, & he was convinced it was benign, so we opt to just go back in 3 months to monitor her. He said her " abnormality" was from a " Cortical Desmoid" A phenomenon that sometimes occurs in Tall children, it mimicks Cancer on x-rays & doctors sometimes confuse the two. Cortical Desmoids usually do not cause pain though from everything I read.. but they said it was the muscles around the abnormality, & the problem would self correct as the child grows.

 Meanwhile.. he sent her to PT for 6 weeks because he said her pain was from the muscles being tugged from the bone lesion. Her first time the PT seemed to help. We went back in 3 months & x-rays revealed it was almost gone! K had little pain.. I thought it was over!

  A few months later while shopping K begins severe pain.. Now it is daily.
 Back to PT we go.. except now it's worse. After PT K's knees swell & she has worse pain that is daily & more intense.  Now both knees hurt. Back to the Orthopedic Ped. Specialist who did more physical test who now says that K has a Femoral Anteversion, along with extremely hyper mobile joints causing her knee to move to much when she walks or does certain movements.
 K has pain going upstairs, walking for long periods or long distances. She tries to play sports, & wants to, but she has alot of pain after.
 We've been though so much.. I just want solid answers. I don't know if this issue going to get worse. Will she need surgery? I really don't want to put her through surgery because I read it's very complcated & can have complications. At the same time, if she does not, how will this effect her quality of life, will it lead to other problems? K is now beginig Aqua Therapy as of last week..
   If anyone has a similar story or knowledge, experience w/ any of this please reach out!!

                      Thank u for reading this!! God bless! :-\

Offline srosky

  • MICROgeek (<20 posts)
  • *
  • Posts: 9
  • Liked: 0
Wow I thought my daughter was the only one, but I think I can help you from her story. She is 18 & was FINALLY diagnosed with excessive femoral anteversisn & excessive internal tibail torsion. She is also hypermobile like your daughter. To make a long story short - she started to experience pain her sophmore year of high school (when she was younger it was occasional pain but nothing that stopped her from sports, etc.) & has not had any relief since - her pain is constant she can't walk or stand for long periods & barely sleeps. She even was home schooled her junior year. I spent a ton of money on alternative treatments, medications, therapies, etc. Nothing worked. Saw MANY orthopedic doctors. Finally went to Dr. Tietge in Michigan (we live in Buffalo but it was worth the drive). He diganosed her & after we gave it a lot of thought she is scheduled for a derotational ostetomy. I hated the thought of surgery but her pain is unbearable & has limited her ability to get on with her life. I found many people on this site who have had surgery with him. Don't know if your daughters are at this point but it may be worth it. Be prepared for other orthopedics to disagree with the need for surgery - that's what we've experienced but none of them have offered anything but physical therapy & that has not worked. Interestingly my daughter is also tall & thin... well if there's anything else let me know....thanks Sue

Offline captainruss

  • SuperKNEEgeek
  • *****
  • Posts: 675
  • Liked: 9
Same story...my 14 year old had a growth plate fracture 6 years ago.  A local practioner put a cast on it.  One side of the growth plate grew, the other did not.  She has rotational issues.  Went to my OS, and two others from All Children's (Johns Hopkins).  First three wanted to do a lateral release.

Thank God I had spent so much time on this site because of my knee.  Anyway, we flew from St Pete Florida to Detroit MI to see Dr. Tietge 6 weeks ago.  We are just waiting for a surgery date.

He is currently booking for November 2013.

But, I believe he will fix it once and fix it right.  No multiple surgeries for my little girl. 

Call Dr. Tietge.
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?