To understand the relationship between the gait patterns in transverse plane and the torsional deformities (TD).

We evaluated the clinical, radiological, and three-dimensional gait analysis data of 55 spastic hemiplegics with TD. We define the TD as follows: 1) femoral anteversion ≥30°, 2) thigh foot angle ≤ -5° or ≥25°, 3) severe foot deformities that could affect the foot progression angle (FPA).

There were 35 males and 20 females with an average age of 8.4 years. 49 patients (89.1%) showed pelvic compensation (PC). In the PC group, 27 patients (55.1%) showed physiologic FPA. However, 22 patients (44.9%) still showed in-toeing (19 patients) or out-toeing (3 patients) gait. Out of the 6 patients (10.9%) who did not showed PC, we could observe in-toeing, out-toeing gait, and physiologic FPA from 3, 2, and 1 patients, respectively. 51 patients (92.7%) had increased femoral anteversion. There were 11 patients (19.6%) with an internal (2 patients) or an external tibial torsion (9 patients), and 30 patients (54.5%) with foot deformities.

We classified the gait patterns and analyzed the relationship between each gait pattern and types of torsional deformities.