Pigeon Toes (Intoeing) is a physical ailment which involves turning of the feet inwards. It may affect either one or both the feet. The condition may develop in the early phase of childhood or may become apparent in later stages when the child starts walking. In most cases, Intoeing can heal itself naturally over the time as the child grows. However, in severe cases, treatment from an orthopedic doctor is required. In most cases the patient responds to conservative methods of treatment. For the others, surgery is required.
Causes
- Gestational problems– The child may not get adequate space in the uterus which causes the legs to turn inwards
- Internal Tibial Torsion– The shinbone is turned inwards. This is generally the cause if Intoeing occurs in the first 2 years of life
- Medial Femoral Torsion or Anteversion– The thigh bone tends to turn inwards causing foot deformity which becomes apparent at the age of 4-5 years
- Other disorders: Neuromuscular disorders such as Cerebral Palsy may also be a cause of the condition
- Genetic factors: Intoeing can also be caused due to genetic factors
Symptoms
- Visible deformity
- Abnormal gait
- Difficulty in walking and running due to lack of balance
- The child is easily fatigued and may stumble very often
- Difficulty in wearing normal shoes
- Pain may be felt during activity
- Swelling
Diagnosis
- A detailed examination of the symptoms, family history and the foot may be conducted
- X-ray imaging may be required to check the position of the bones and soft tissues
- The range of motion may be assessed through physical tests
Treatment
- Bracing– The child may be asked to wear a night brace or a removable brace throughout the day to correct the position of the foot. It comprises of a special shoe made with connecting bars that is fixed on the leg. Bracing may be done even after birth if the baby is found to be deformed
- Orthotic devices– Special shoe inserts may be used to support the affected foot
- Plaster: Leg and the foot may be fixed in a plaster for a specific period of time.
- Surgery: The orthopedic doctors may recommend a surgery if the condition exists beyond 9-10 years of age. The procedure involves resetting of the tibia or the femur as well as the foot bones to improve the shape and create a proper gait.