Pigeon Toe

A baby's feet generally turn in at birth. The feet usually straighten out on their own as the child grows, but not always. Sometimes the feet continue to curve toward each other, not straight ahead. This is called metatarsus adductus, in-toeing, or pigeon toe. It is not painful and it rarely causes problems with walking.

CAUSES

  • The baby's position in the mother's womb. The feet are forced into an inwardly curved position.

  • A bone in the lower leg is twisted (internal tibial torsion). This causes the leg and foot to turn in. The turning-in begins below the knee.

  • A bone in the thigh is twisted (excess femoral anteversion). This causes the lower leg and feet to turn in. This twist is located at the hip.

SYMPTOMS

  • The outside of the feet are curved. Look at the soles of the feet while the child is lying down.

  • Toes turn in while walking.

  • Knees point inward. This may be seen when the child walks.

DIAGNOSIS

  • A physical exam may be needed. The child's caregiver may:

  • Look at the child's feet, legs, knees, and hips.

  • Ask questions about the child's birth and the mother's pregnancy.

  • Ask if anyone else in the family has pigeon toes. This condition can run in families (genetic).

  • The caregiver may order imaging tests. They produce pictures that will show if a bone problem is causing pigeon toes. Options include:

  • X-rays of the feet, legs, and hips.

  • Computed tomography (CT scan). A CT scan will show more detail of the angles of the bones.

TREATMENT

Most children with pigeon toes do not need treatment. Sometimes, stretching exercises help. The foot usually straightens on its own by age 8. A twisted bone often straightens by itself too. Even if the turning in does not go away, treatment still may not be needed. Pigeon-toed children usually do not have trouble walking, running or jumping.

For serious cases which do not get better with the growth of the child, treatment options may include:

  • Special shoes, braces, or casts. These may help straighten a curved foot or a twisted bone. They usually are used before the child walks.

  • Surgery. Surgery may be needed to straighten a bone that is severely twisted.

HOME CARE INSTRUCTIONS

  • If any treatments were prescribed:

  • Make sure the child wears special shoes or braces correctly. Ask yourcaregiver how often they should be worn and for how long.

  • If a cast is put on, ask your caregiver for care instructions. Ask if the cast can get wet.

  • If surgery is done, you will be given specific directions. They will vary by the type of surgery. Discuss any questions you have with the child's caregiver.

  • If no treatments were prescribed:

  • Watch for changes in the child's legs and feet. Also note any changes in the way the child walks.

  • Keep all follow-up appointments as directed. Tell the child's caregiver about any changes you have noticed.

  • Do not worry about the child tripping or falling. Being pigeon-toed is seldom the cause.

SEEK MEDICAL CARE IF:

  • The child's feet start to turn in more.

  • The child has trouble with any braces or special shoes.

  • The child continues to be pigeon-toed after age 8.

  • After a surgery:

  • You notice blood or any liquid oozing from the site of the cut (incision).

  • If the area around the incision swells.

  • Your child has an oral temperature above 102° F (38.9° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • After a surgery, your child has an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • There is increasing pain, which gets worse with straightening and bending the toes.