By Dr. Lynn Staheli, MD. The natural history of the tibia is to externally rotate with growth. This corrects the common internal tibial torsion. However, external tibial torsion often becomes greater during mid and late childhood. Sometimes it becomes severe and requires operative correction. Make correction in the distal tibia. Unilateral external tibial torsion is usually on the right side. For more information and videos, please visit http://globalhelp.org.