Idiopathic Rotational Abnormalities of the Lower Extremities in Children and Adults

* Rotational malalignment of the lower extremity is a potential cause of hip, knee, and ankle pain. * Physical examination must include observation of gait and an assessment of femoral rotation and the thigh-foot axis with the patient prone. * Advanced imaging helps to quantify the degree of deformity, improving the accuracy of the preoperative plan. * Surgical correction of rotational malalignment of the femur and tibia is reserved for severe, symptomatic deformity. * Future software that allows for 3-dimensional assessment of alignment and preoperative planning will further aid in the correction of the complex deformities.