Intoeing for the Orthopedic Patient

Important information about intoeing:

Intoeing is a condition where your child’s feet turn toward each other when they are walking. Your child may trip over their feet at times. You may notice this more often when they are tired. Some children sit in a “W” position on the floor.

Who has intoeing?

About 10% of people intoe. Some of this is due to the curled position of your baby in the womb. Children inherit the tendency to intoe from their parents. In the past, children who intoed were treated with casts or special braces. Your healthcare provider may ask you if anyone in your family used these as children.

What causes my child to intoe?

Your child may have one, two, or all these conditions.

• The turning inward of one or both feet (metatarsus adductus) (Figure 1)

• The turning inward of the tibia, or shin bone (tibial torsion) (Figure 2)

• The turning inward of the femur, or thigh bone (femoral torsion or anteversion) (Figure 3)

Should I be concerned if my child intoes?

No. Intoeing does not cause your child any pain. It will not cause any permanent damage, such as arthritis or disfigurement. Tripping will continue to improve as your child grows and the bones partially straighten themselves out. Surgery is rarely needed.

What can be done about intoeing?

Nothing needs to be done about intoeing from tibial torsion or femoral anteversion. If your child has metatarsus adductus, your healthcare provider will discuss treatment options. After many years of research, there is no evidence that using braces or special shoes will help speed up nature’s progress. The natural growth of the femur and tibia will cause them to straighten out as your child grows. Since adults still intoe, and this is an inherited condition, your child may still have some mild intoeing when they are older. Your healthcare provider may also examine the parents’ or siblings’ feet during the visit to help understand the genetic causes.

• About 95% of flexible metatarsus adductus will improve over a period of 2-4 months regardless of treatment. However, your child may need routine follow-up appointments.

• Tibial torsion continues to improve until about age 3-10.

• Femoral anteversion continues to improve until about age 8-10. Intoeing is most noticeable, and tripping is at its worst, between ages 2 and 4. Children with femoral anteversion like to sit in the “W” position. This is not harmful; it is simply the position in which the hips feel most comfortable.

Your healthcare team will explain this condition and the best treatment.

Division of Orthopaedics

Weekdays:

215-590-1527 if your cast was placed in our Philadelphia, Princeton or Voorhees sites.

If your cast was placed in our King of Prussia office, call 215-590-6919.

Nights, weekends, and holidays:

Call 215-590-1000 and ask the operator to page the orthopedic resident on call.

Reviewed March 2024 by Emily Stegonshek, CRNP