BENGALURU: When a child learns to take his first steps, he not only falls or trembles but sometimes his toes are not straight and appear to be turned inwards. This could be because of a condition termed as ‘pigeon toes’. Also referred to as in-toeing, pigeon toes are quite common in babies or young children for multiple reasons. It is described as the condition where the toes are turned inwards while walking or running. Commonly observed in children, pigeon toes are not necessarily a cause of concern as most children grow out of them before they reach teenage years. However, it is important for parents to be aware and know the root causes of their child’s pigeon-toed situation.
Causes
n A condition linked to being pigeon toed is tibial torsion. This is the condition where the shin bone which is the tibia bone (the bigger of the two bones) in the lower leg is turned inward and in turn, pulls the foot also inward along with it. This usually occurs while the child is in the womb. However, after birth, as the child grows and the legs grow longer, the bones usually untwist and rotate to the proper place naturally. Tibial torsion is mostly noticed when the child begins walking and in severe cases trips due to one foot catching on the opposite heel.
n One of the other conditions which is more commonly related to in-toeing is that of a twisted upper thigh bone, the bone could be turned in at the hip. This condition makes the knees and the feet to turn inward while walking. It is also called femoral anteversion and is present from the birth itself. Giving a ‘bow-legged’ appearance alongside being pigeon-toed, this condition mostly comes into notice once the child is about five years old. If the child is suffering from this condition, s/he is likely to often sit with his/her knees turned inwards and feet outward in a W shape as that would be more comfortable.
This is one clue that the parents can look out for. nAnother condition is usually that of a curved foot. Also called metatarsus adductus, this is the condition in which the foot curves inwards from the middle of the foot area to the toes.
This is common in infants. If the child only has the front part of the foot turned inward and that is not in-toeing, that’s usually the case of a clubfoot which is again something usually picked up at birth. Some severe cases of the curved foot may look like clubfoot where the entire feet bends inward but clubfoot and pigeon toes are not the same thing. Pigeon toes or in-toeing is mostly seen in children less than 2 years of age. – The author is consultant paediatrics, Columbia Asia Hospital Hebbal