In-toeing is a congenital deformity caused by a persistent rotated position in utero. While it may take several years to restore the normal feet appearance, the majority of children who's feet intoe will typically outgrow it.

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Causes of In-Toeing

Fetus in Utero

In-toeing (also known as "pigeon toes") is a common condition in growing children primarily caused by a persistence of fetal position. If a baby is uninterruptedly folded inside the uterus with the legs and feet turned in to best fit into the small space, they will often maintain this rotated position after birth. The persistent twisting of the legs can cause in-toeing, and it may take several years for the child to "un-twist." While walking, children who in-toe may seem clumsier than children who don’t. In-toeing is usually due to persistent twist in one or more of the following three areas: the feet, legs or hips.

Matatarsus Adductus In-Toeing

Metatarsus adductus occurs when the child's foot curves in at the middle, giving the foot a "bean-shaped" appearance. For the majority of patients with metatarsus adductus will resolve on its own. For patients suffering from a stiff metatarsus adductus, treatment to correct the normal appearance of the feet may be recommended. Stiff metatarsus adductus is most often treated with casts or special shoes, and will rarely require surgery to restore appearance. Even adults who have metatarsus adductus do not have any disability or increased foot pain.

Tibial Torsion In-Toeing

Tibial Torsion In-Toeing

Tibial torsion is a form of in-toeing caused by persistent "leg twist". Usually most evident when the child first starts walking, tibial torsion will cause the kneecaps to point straight ahead and the feet to turn inward. Treatment is very rarely needed for tibial torsion, and most children will outgrow it by the time they start kindergarten.

Femoral Anteversion In-Toeing

Femoral anteversion is the angling of the thigh bone (femur) to the hip joint, that can increase the risk of developing in-toeing. Children with femoral anteversion will often sit in a "W" position and may have an "eggbeater" run, in which their legs whip out to the side. Treatment is rarely required and most kids outgrow it by the time they are 10.

In-Toeing in Tampa-St. Petersburg, Florida

With 7 fellowship trained pediatric surgeons specializing in orthopaedics and scoliosis, the Children’s Orthopaedic and Scoliosis Surgery Associates team provides the highest level of comprehensive care to patients in the Tampa, Florida area. To learn more about Children’s Orthopaedic’s specialties, please schedule an appointment at one of our Tampa-St.Petersburg locations.