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What is Intoeing and Does My Child Need Treatment? Los Angeles, CA
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Intoeing is a common disorder in children where the feet turn inward when standing, running or walking. It is often considered a normal part of childhood development, but there are times when treatment is needed to improve the condition. Children with this condition are often referred to as “pigeon-toed” because of the position of their feet when they stand and walk, which resemble the feet of pigeons or other types of birds.

Intoeing does not cause arthritis and normally doesn’t cause any pain. If your child has associated pain, swelling or a limp, they should be evaluated by a DOCS Health orthopedic specialist to assess if treatment is required to improve the condition and avoid worsening over time. Surgery is usually not required; however, the only way to be sure is to see a specialist.

What Causes Intoeing and How is it Treated?

Little is known about the initial cause of intoeing. However, it is known to run in families, so genetics is thought to play a part. The position of the baby in the womb could also be a factor. There are three main disorders that cause intoeing; metatarsus adductus, tibial torsion and femoral anteversion.

Metatarsus adductus (also known as metatarsus varus) is a condition where babies are born with feet that are turned or bent inward. The condition often affects both feet. Usually, babies will have improvement within 6 months after birth. If improvement is not seen, then specialized shoes or casts may be needed to help straighten the feet. These specialized shoes or casts are specially designed to straighten the feet without causing pain.

Tibial torsion is a condition where the child’s shinbone turns inward. If the tibia (shinbone) is turned or twisted inward, then the condition generally resolves by itself by the age of 3. If the condition doesn’t self-correct by the age of 8, then surgery can be considered to straighten the tibia. This type of surgery is called tibial derotational osteotomy.

During this surgery, the tibia is cut, rotated and fixed into a straighter position. Casting is then required to allow the bone to heal. Normally, a plate and screws are used to hold the bone in its new position. In some cases, an intramedullary rod may be placed inside the bone to help position the bone and improve healing.

Femoral anteversion is a condition where the femur (thigh bone) turns inward. Femoral anteversion can be noticeable in children around the age of 5 or 6. It usually occurs in both legs and is very common, especially in girls. In most cases, it self-corrects by the age of 8-10, but in rare cases where the condition persists beyond age 9-10, surgery can be considered.

Surgery for femoral anteversion is called a femoral derotational osteotomy. This type of surgery is similar to that for tibial torsion. The femur bone is cut and rotated and an intramedullary rod is placed inside the bone to help position the bone. The rod allows the bone to bear weight, so walking is tolerated almost right away without the need for a brace or a cast. Typically, a child will talk with crutches or a walker for 4 to 6 weeks to reduce pain while the bone heals.

How to Know Which Condition Your Child Has and if Treatment is Required

Most children outgrow intoeing between the ages of 8 and 10, but it’s difficult to know which condition your child is facing and if there are complications requiring treatment. If the condition is left untreated, it can lead to complications, such as an unbalanced gait that can cause strain, reduced athletic ability including problems running and jumping and foot deformities including flat feet, hammertoes and bunions.

To be sure which condition your child may have and find out if they need treatment, a physical examination of your child’s leg will be required. A DOCS Health orthopedic specialist can use diagnostic imaging to evaluate your child’s leg bones, including an observation of the leg bones in motion.

If you have a child with an intoeing condition or if you’re not sure, contact our team at DOCS Health for a consultation. Our orthopedic specialists can determine which intoeing condition your child may have, the severity of the condition and if your child may require intoeing treatment. Call our clinic in Los Angeles to schedule a consultation or contact us via our online web form.

Posted on behalf of DOCS Health

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