Normal variation of talar tilt of the ankle in children.

Sixty normal children were examined clinically and radiologically, using a special apparatus with a goniometer and a tensometer to standardize stress tests when applying valgus and varus forces to the ankle. It was noted that the clinical movement of inversion is not entirely due to a subtalar movement; indeed a talar tilt appears to be physiological. The range of normal in these patients, age range 6 to 15 years, was 0 to 27 degrees with an average talar tilt of 7 degrees . The talar tilt is not necessarily the same in both ankles of any one individual and it is never noted in eversion. The talar tilt is more marked in younger children in the position of equinus.When interpreting radiographs of recently injured ankles, it is wise to recall that a talar tilt need not be the result of trauma and that it may be physiological and yet unequal on both sides.