Intoeing gait in children

Abstract

OBJECTIVE. To review the aetiology and management of intoeing.

DATA SOURCES. Medline and non-Medline literature search, and personal experience.

STUDY SELECTION. Studies that provided evidence-based information about the aetiology and management of paediatric intoeing gait were selected.

DATA EXTRACTION. Data were extracted and reviewed independently by both authors.

DATA SYNTHESIS. An intoeing gait affects many children and, as with flexible flatfoot, bowleg, and knock-knee, it falls into the category of physiological problems that occur in normal children. The usual causes are excessive femoral anteversion, internal tibial torsion, and metatarsus adductus. Management is based on understanding the causes and the natural course of the condition and the effectiveness of various treatment modalities. Unfortunately, due to poor understanding of the condition, intoeing is commonly overtreated with braces or special footwear.

CONCLUSIONS. Intoeing is one of the most common conditions encountered in paediatric orthopaedic practice. It is important to make an early diagnosis of pathological causes of intoeing such as cerebral palsy and developmental dysplasia of the hips so that treatment can be commenced as soon as possible.