Pediatric Intoeing (Pigeon Toes)
What is Pigeon Toes?
Pigeon toes, or intoeing, is a condition where children feet turn inward when walking or running.
It is commonly called “Pigeon-Toed”, and it is one of the most common reasons for orthopedics consultation.
What causes Pigeon Toes?
Walking with their toes pointing inward isthe normal position of child’s foot when he is in a standing position or he is walking.
It depends on three factors:
- the shape of the foot
- the shape of the femoral neck or femoral anteversion
- the tibial internal rotation
These factors are physiological in children and need no treatment, resolving spontaneously with time.
Also Metatarsus Adductus can be a pigeon toe cause.
When the baby starts walking and the bones grows in length, muscular tensions produces a progressive “twisting” of the bones until they reach the adolescent or adult position. Hence the mnemonic form for moms “9 months to roll in the belly and 9 years to roll out“.
As the child grows the rotations of the femur and the tibia change (physiological external rotation – “unrolling”), the different muscle groups increase their strength and the foot position in the space changes, always moving outward.
How to fix Pigeon Toe
Most children with intoeing do not require treatment. It is a condition that corrects itself over time.
Braces, casts or special shoes aren’t usually needed.
In any case, a clinical evaluation is fundamental to exclude other attitudes or malformations
Nevertheless if this attitude persist into adolescence or it is associated to other pathologies as neuromuscular diseases, it may require surgery.
Prof Portinaro’s experience with Pigeon Toe
Prof. Portinaro is one of the most qualified surgeons in the world for foot diseases and treatments.
He has been treating this condition with a non-surgical approach at first, examining more than 3000 patients.
Prof. Portinario performed more than 1.000 surgeries related to pigeon toes.