A simplified technique for determining foot progression angle in children 4 to 16 years of age

Foot progression angle was determined in 400 normal children ranging in age from 4-16 years using a new clinically available assessment technique. Children ages 4-5 were found to have an average out-toeing of 2.8 degrees (1 STD = 6.9 degrees). The average foot progression angle increased with age to 7.3 degrees at age 16 (1 STD = 4.4 degrees). Univariate analysis of these data found that age, tibial alignment, arch index, and the ratio of body weight to body height significantly affected foot progression angle. If, for children 4-16 years of age, two standard deviations from the average of 4.2 degrees out-toeing is taken as a normal range of variance, -8 degrees (in-toeing) to +16.4 degrees (out-toeing) would be acceptable for these ages. The measurement technique is described in detail, and the normative values and age-specific results are reviewed and discussed.