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Conditions

Pigeon Toed

Overview

The medical term for “pigeon-toed” is intoeing. The condition is characterised by the child’s feet turning inward when walking or running, instead of pointing straight ahead. In the vast majority of children younger than 8 years old, intoeing will almost always correct itself without the use of casts, braces, surgery, or any special treatment. Intoeing by itself does not cause pain, nor does it lead to arthritis. A child whose intoeing is associated with pain, swelling, or a limp should be evaluated by an orthopaedic surgeon.

Causes, Symptoms and Recommended Treatments

There are three conditions that often cause intoeing:

  • Curved foot (metatarsus adductus) – this is when a child's feet bend inward from the middle part of the foot to the toes. Some cases may be mild and flexible, while others may be more obvious and rigid. The condition usually improves without treatment during the first 4-6 months of life. Some babies over six months with severe deformity or very rigid feet may require casts or special shoes which have a very high rate of success. Surgery is seldom required.
  • Twisted shin (tibia torsion) – this occurs before birth and is characterised by the child's lower leg (tibia) twisting inward. After birth, an infant's legs should begin to gradually rotate to align properly. The condition almost always improves without treatment however surgery to reset the bone may be done in a child who is at least 8 to 10 years of age and has a severe twist that causes walking problems.
  • Twisted thighbone (femoral anteversion) – this occurs when a child's thighbone (femur) turns inward. It is often most obvious at about 5 or 6 years of age. The upper end of the thighbone, near the hip, has an increased twist, which allows the hip to turn inward more than it turns outward. This causes both the knees and the feet to point inward during walking. Children with this condition often sit in the "W" position, with their knees bent and their feet flared out behind them. The condition usually spontaneously corrects in almost all children as they grow older. Studies have found that special shoes, braces, and exercises do not help. Surgery is usually not considered unless the child is older than 9 or 10 years and has a severe deformity that causes tripping and an unsightly gait.