Orthopedics Book

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In-ToeingAka: Toeing-In, Intoeing, Pigeon-Toed

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  1. General
    1. Intoeing encases several underlying leg abnormalities
    2. Intoeing may occur at any level down leg kinetic chain
      1. Hip: Medial Femoral Torsion (Femoral Anteversion)
      2. Leg: Medial Tibial Torsion (Internal Tibial Torsion)
      3. Foot: Metatarsus Adductus
    3. Intoeing causes by age (most common causes)
      1. Infant: Metatarsus Adductus
      2. Toddler: Internal Tibial Torsion
      3. Child: Femoral Anteversion (usually bilateral)
  2. Approach
    1. Step 1: Evaluate gait and rotational profile
      1. See Foot Progression Angle (Gait Rotational Angle)
      2. Confirm In-toeing with Out-toeing
      3. Level of abnormality may be apparent by gait
    2. Step 2: Evaluate hip rotation
      1. See Hip Rotation Evaluation in Children
      2. Limited lateral hip rotation (less than -10 to 20)
        1. Medial Femoral Torsion
    3. Step 3: Evaluate Thigh to Foot Angle
      1. Negative angle suggests Medial Tibial Torsion
    4. Step 4: Evaluate for foot deformity
      1. Curved foot suggests Metatarsus Adductus
    5. Step 5: Evaluate for toe deformity
      1. Great toe abducted suggests searching toe
  3. References
    1. Schmale (2003) AAFP Board Review, Seattle

Toeing-in (C0231791)

ConceptsFinding (T033)
EnglishIn-toeing, Intoe, Intoeing, Intoing, Overlapping toe - acquired, Pigeon toe, Toeing-in
Spanishdesviacion interna de los dedos de los pies, metatarso varo
Parent ConceptsGait abnormality (C0575081), Finding of lower limb (C0575986), Toe finding (C1320457)
SourcesMTH, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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