Intoeing gait

What it is

Intoeing gait is walking with the toes pointing inward.

Causes and risk

There are 3 main causes: femoral anteversion, metatarsus adductus and internal tibial torsion. Intoeing gait is also one of the complications of clubfoot.

How it presents

• Femoral anteversion: can be hereditary and is often bilateral. Internal rotation is more than 70 and external rotation is less than 20. Most cases resolve spontaneously by age 10.
• Internal tibial torsion: seen at 1-3 years and resolves spontaneously by age 4. The thigh-foot angle runs from 5 internal rotation to 10 external rotation, and the transmalleolar axis is more than 15 degrees internal.
• Metatarsus adductus: the lateral border should be straight, and there is a medial crease.