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Description of the Symptom

In-toeing and out-toeing postures may be seen during quiet stance or gait.1,2,3 These postures are recognized by an excessive bilateral or unilateral angulation of the foot longitudinal axis toward or away from a child's line of forward progression, respectively (Fig. 61-1). This chapter describes possible causes of in-toeing and out-toeing in a child.


Out-toeing bilaterally with left foot more affected than right.

Special Concerns

  • Post-traumatic changes in lower extremity alignment or a painful limp

  • Progressive limp leading to refusal to walk with or without pain

  • Grossly asymmetric presentation of lower extremity alignment

  • History of multiple fractures

CHAPTER PREVIEW: Conditions That May Lead to In-Toeing and Out-Toeing in a Child
Common Ages at Which In-Toeing and Out-Toeing Present in a Child

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