Managing Intoeing in Children

Abstract

Intoeing can be accurately diagnosed using a history, physical examination, and torsional profile. (Strength of Recommendation [SOR]: C, based on expert consensus.) The three most common causes of intoeing (i.e., metatarsus adductus, internal tibial torsion, and increased femoral anteversion) initially should be managed conservatively with serial examinations and reassurance. (SOR: C, based on expert consensus.) Patients with rigid metatarsus adductus should have serial casting if it persists beyond six months of age. (SOR: C, based on expert consensus.) Patients with internal tibial torsion that persists into midchildhood should be referred for surgical correction. (SOR: C, based on expert consensus.) Patients with increased femoral anteversion that persists past eight to 10 years of age should be referred for surgical correction. (SOR: C, based on expert consensus.)