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Book

Intoeing

Anter S. Gonzales  1 , Ahmed Y. Saber  2 , George Ampat  3 , Magda D. Mendez  4
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
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Book

Intoeing

Anter S. Gonzales et al.
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Excerpt

Deformities and angular variations of the lower extremities are one of the most common reasons for referral to pediatric orthopedics, with in-toeing seen mostly in infants and young children. Also known as “pigeon-toeing,” this is caused by a rotational variation anywhere in the lower extremity that causes the foot to point inward.[2]

In coming to understand variational pathologies of the lower limb, it is important to be familiar with the normal growth and development of children’s lower extremities. Neonates are born with about 40 degrees of femoral anteversion or forward rotation of the femoral neck. This increased internal rotation of the hip decreases over time. By about 10 years old, the degree of anteversion decreases by about half. Any deviation from the expected course of limb development and rotation should be recognized and differentiated from the persistence of early angulation, to pathologies preventing normal rotation.

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Conflict of interest statement

Disclosure: Anter Gonzales declares no relevant financial relationships with ineligible companies.

Disclosure: Ahmed Saber declares no relevant financial relationships with ineligible companies.

Disclosure: George Ampat declares no relevant financial relationships with ineligible companies.

Disclosure: Magda Mendez declares no relevant financial relationships with ineligible companies.

References

    1. Gonzales AS, Saber AY, Ampat G, Mendez MD. StatPearls [Internet] StatPearls Publishing; Treasure Island (FL): 2023. Jul 22, Intoeing. - PubMed
    1. Boyer ER, Patterson A. Gait pathology subtypes are not associated with self-reported fall frequency in children with cerebral palsy. Gait Posture. 2018 Jun;63:189-194. - PubMed
    1. Dobbe AM, Gibbons PJ. Common paediatric conditions of the lower limb. J Paediatr Child Health. 2017 Nov;53(11):1077-1085. - PubMed
    1. Evans AM. Mitigating clinician and community concerns about children's flatfeet, intoeing gait, knock knees or bow legs. J Paediatr Child Health. 2017 Nov;53(11):1050-1053. - PubMed
    1. Rerucha CM, Dickison C, Baird DC. Lower Extremity Abnormalities in Children. Am Fam Physician. 2017 Aug 15;96(4):226-233. - PubMed

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