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[Idiopathic toe walker child. Diagnosis and spontaneous evolution]
1Service de rééducation orthopédique et traumatologique, hôpital national de Saint-Maurice, 14, rue du Val dOsne, 94410, Saint-Maurice, France
Summary
Idiopathic toe walking often resolves spontaneously by age 8, especially when ankle dorsiflexion exceeds 10 degrees. Persistent cases with limited dorsiflexion may require intervention.
Area of Science:
- Pediatrics
- Orthopedics
- Neurology
Background:
- Idiopathic toe walking is a common gait abnormality in children.
- Understanding its natural history and predictors of resolution is crucial for clinical management.
Purpose of the Study:
- To analyze clinical and etiological aspects of idiopathic toe walking.
- To determine the natural evolution without treatment and optimal age for correction.
Main Methods:
- Retrospective analysis of 69 children admitted between 1973 and 1998.
- Review of 41 children during growth, with only 6 receiving treatment.
- Assessment of ankle dorsiflexion (knee extended and flexed) and family history.
Main Results:
- Toe walking most common at 12-18 months; initial examination between 1-4 years.
- Normal neurological examination in 46/69 children; no neurological impairment identified.
- Spontaneous correction occurred in 32 cases (3-8 years) with >10 degrees ankle dorsiflexion (knee extended).
- Persistent toe walking (>10 years) observed in 4 cases with <10 degrees dorsiflexion (knee extended).
Conclusions:
- Idiopathic toe walkers with >10 degrees ankle dorsiflexion (knee extended) often resolve spontaneously.
- Cases with triceps contracture and <10 degrees dorsiflexion may require interventions like triceps lengthening.