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| State University of New York at Buffalo - Department of Orthopaedics |
| INTOEING / OUT-TOEING |
| One of most common developmental problems in children is the occurrence of intoeing/out-toeing. If you have noticed that your child's feet turn in (or out), this condition is often considered normal and, with time, your child's feet will return to the normal position without the need for treatment. |
| WHAT IS INTOEING / OUT-TOEING? |
| Out-toeing usually occurs during the first 12 months due to the hip positioning while in the uterus. Out-toeing will resolve without any form of treatment. Intoeing develops from one of three areas: the foot, the knee, or at the hip. |
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The Foot: Metatarsus Adductus This is the most common cause of intoeing from birth to 2 years of age and is believed to be caused by positioning in the uterus, or family history. If the foot is flexible and can be gently pulled into the correct position, no treatment is necessary. If the foot is rigid and your child is under 8 months of age, your physician may recommend casting. |
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The Knee: Tibial Torsion This is noticed most commonly during the second year of life after the child has started walking. The shin bone (tibia) is slightly twisted or rotated causing the foot to turn in. This may be due to the position while in the uterus or a family history, and is considered to be within the range of normal leg formation |
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The Hip: Femoral Anteversion Children between the ages of 3 and 7 may walk with their knee caps pointing inward. This is caused by a slight rotation of the top of the hip bone (femur) in the socket of the hip. This occurs more often in girls, and is also considered to be within the range of normal leg formation. |
| HOW IS IT TREATED? |
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Observation is the best treatment for intoeing and out-toeing. You can take pictures of your child standing, at yearly intervals, and then compare the progression of the straightening process. Very rarely is another form of treatment necessary. Only if, for some reason, your child does not "grow out of this condition" by the age of 10 will surgical options be considered. |
| COMMONLY ASKED QUESTIONS |
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1. Your child's intoeing is a common developmental condition. 2. BRACING, TWISTER CABLES, AND CORRECTIVE SHOES ARE NOT NECESSARY. Many years ago, it was believed that these treatments helped correct intoeing, but years of studies have shown them NOT to be effective. 3. Falling is a part of the learning to walk process and is not exclusively caused by intoeing. 4. Intoeing will not affect your child's abilities to walk, run, play, or lead a normal life. |
| Back to the Children's Hospital of Buffalo - Department of Orthopaedics |