Intoeing can be caused by:
1) Internal femoral torsion: an inward twist of the leg bone.
2) Femoral antetorsion or internal femoral torsion: an inward twist of the thigh bone.
3) Femoral anteversion: an inward rotation of the thigh bone (positional) which may originate at the hip joint.
4) Metatarsus adductus: inward bowing of the foot, a “C-shaped” foot.
Metatarsus adductus (see image on top right) can be treated effectively by the following techniques:
1) Manipulation: most effective from birth through about 10 months of age.
2) Serial casting: the pediatric podiatrist places a series of casts, each one with foot held straighter than the prior cast until the deformity is resolved. Effective from about 6 weeks of age through about 14 months.
3) Wheaton brace:
this commercial brace can be used to treat metatarsus adductus and internal tibial torsion. It is effective from about 6 months of age through age 2.
Surgical treatment may be required for severe cases or if correction is not achieved by the non-surgical treatments listed. The conservative treatments are generally effective if utilized early when the joint of the foot are developing and “malleable.”
Internal tibial torsion can be treated effectively by the following techniues:
1) Serial casting
2) Dennis Browne splint: this is the old fashion bar affixed between shoes that infants sleep with at night.
3) Wheaton brace