What question did this study set out to answer?

To investigate how lower extremity torsional deformities influence gait dysfunction in a specific case.

February 8, 2026JBJS Case Connector0 citationsOpen Access

Lower Extremity Torsional Deformity as an Overlooked Cause of Gait Dysfunction

NKNour KabbesMcGill University SMSepehr MehrpouyanMcGill University JDJustin DragerShriners Hospitals for Children - Canada

Key Points

To investigate how lower extremity torsional deformities influence gait dysfunction in a specific case.
Clinical examination of a 15-year-old girl with knee pain and abnormal gait.
Imaging with computed tomography (CT) showing femoral and tibial torsion.
3-dimensional gait analysis to assess malalignment.
Surgical intervention with femoral and tibial osteotomies to correct torsion.
CT showed 44° of femoral anteversion and 35° of external tibial torsion.
Post-surgery, gait normalized and clinical scores improved significantly.
Dynamic sagittal and coronal gait dysfunction attributed to torsional malalignment.

Abstract

Case: A 15-year-old girl presented with significant right anterior knee pain and a varus-hyperextension gait pattern mimicking knee subluxation. Computed tomography (CT) revealed 44° of femoral anteversion and 35° of external tibial torsion. Magnetic resonance imaging and X-rays failed to demonstrate any abnormalities. Clinical examination supported by CT, EOS, and 3-dimensional gait analysis revealed axial malalignment. Femoral and tibial torsional osteotomies normalized gait, and clinical scores improved. Conclusion: This case highlights how torsional malalignment can produce dynamic sagittal and coronal gait dysfunction. Rotational correction resolved symptoms, emphasizing the need to include torsion assessment in patients with unexplained knee pain and gait dysfunction.

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