Intoeing may cause the child to stumble and trip but it does not cause pain and does not lead to other conditions such as arthritis. There may be difficulty with getting shoes to fit correctly, and some children may be concerned about looking different.
Metatarsus adductus (curved foot)
This is thought to result from the curled-up position of the baby before birth. The child’s feet may curve in from the middle of one or both feet and may be shaped like kidney beans. Mild to moderate forms of this condition tend to correct themselves in the first four to six months of life. Metatarsus adductus is also known as metatarsus varus.
Femoral torsion (twisted thighbone)
The femur (thigh bone) is the bone that runs from the hip to the knee. In femoral torsion (also called femoral anteversion), the femur is rotated inwards, causing the knees and feet to point inwards. This is common in babies and the condition usually resolves by the age of 10 years. It is often first noticed between the ages of two and four years. Children with femoral torsion may have difficulty sitting in a cross-legged position and tend to sit on their knees with their feet flared out behind them.
Tibial torsion (twisted shin)
The tibia (shin bone) is the bone at the front of the leg that runs from the knee to the ankle. In tibial torsion, the tibia is rotated inwards, causing the feet to point inwards. Again, this is common in babies, and the tibia normally straightens by the age of 18 to 24 months. If tibial torsion does not resolve, it is usually first noticed when the child starts walking.
In cases of severe metatarsal adductus, casting or splinting of the feet may be recommended. The cast/splint stretches the feet into a straight position. It is recommended that this treatment is completed before the child is of walking age. Surgery to straighten the foot is seldom required. There may be some residual curve in the feet after treatment but this will not affect activity and does not cause any discomfort.
Tibial and femoral torsion nearly always resolve without treatment. However, in cases of severe tibial or femoral torsion that cause difficulties with walking, surgery may be recommended. Surgery involves cutting the femur or tibia and repositioning it outward, so the toes point straight ahead. Surgery is not usually considered until after the age of eight years as the leg bones continue to grow straighter until around that age. Splints, special shoes and exercise programmes have been shown not to help in the treatment of tibial and femoral torsion.
O’Toole, M.T. (Ed.) (2013). Metatarsus varus. Mosby’s Dictionary of Medicine, Nursing & Health Professions (9th ed.). St Louis, MI: Elsevier Mosby.
MedlinePlus (2016). Metatarsus adductus (Web Page). Bethesda, MD: US National Library of Medicine (NIH). https://medlineplus.gov/ency/article/001601.htm [Accessed: 18/10/17]
Last Reviewed – October 2017