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Toeing-In refers to a condition where the feet point inward, not straight. The in-toeing trait is commonly seen in young children.
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- Metatarsus adductus is seen right after birth. In-toeing due to internal tibial torsion or femoral anteversion is detected when the child begins walking.
- In-toeing does not cause pain or gait difficulties
- The incidence of bow legs (genu varum) is high in children with in-toeing
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The cause is unknown, but there are
some factors that may play an important role.
- Family history
- Position of fetus in the womb
- Habitual awkward positioning after birth (i.e., reverse-tailor position, kneeling position and lying face down with the feet twisted inward)
- The are three types of deformities that cause toeing-in:
- Metatarsus adductus -- in this condition, the feet are bent inward. A slight inward bending of the foot is a normal condition in newborn babies. This usually disappears without treatment one year after the birth.
- Internal tibial torsion -- In-toeing results from the inward twisting of the shinbone (tibia). It usually returns to its normal position by the age of 4.
- Excessive femoral anteversion -- Femoral anterversion is the inward twisting of the thigh bone (femur). It usually corrects itself before the age of 6
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- The diagnosis is based on a clinical examination
- Doctors will determine the type of deformity that causes in-toeing by a physical examination.
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- Metatarsus adductus usually corrects itself, so treatment is not necessary. If the deformity is persistent after 6 or 7 months, it can be straightened by manual stretching, passive stretching exercises and corrective shoes. Surgical correction is considered if the severe deformity persists after 2 years.
- Internal tibial torsion, femoral anteversion -- Spontaneous correction usually occurs with age. Poor sitting or lying positions should be avoided. Special shoes or braces are not helpful.
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