Idiopathic toe walking

The Journal of the American Academy of Orthopaedic Surgeons
Matthew E Oetgen, Sean Peden

Abstract

Toe walking is a bilateral gait abnormality in which a normal heel strike is absent and most weight bearing occurs through the forefoot. This abnormality may not be pathologic in patients aged <2 years, but it is a common reason for referral to an orthopaedic surgeon. Toe walking can be caused by several neurologic and developmental abnormalities and may be the first sign of a global developmental problem. Cases that lack a definitive etiology are categorized as idiopathic. A detailed history, with careful documentation of the developmental history, and a thorough physical examination are required in the child with a primary report of toe walking. Treatment is based on age and the severity of the abnormality. Management includes observation, stretching, casting, bracing, chemodenervation, and surgical lengthening of the gastrocnemius-soleus complex and/or Achilles tendon. An understanding of idiopathic toe walking as well as treatment options and their outcomes can help the physician individualize treatment to achieve optimal results.

Citations

Mar 24, 2016·Gait & Posture·Mark L McMulkinGlen O Baird
Apr 10, 2015·Archives of Disease in Childhood. Education and Practice Edition·Shobha Sivaramakrishnan, Arnab Seal
Jun 11, 2014·Research in Developmental Disabilities·Giulio E LancioniSerafino Buono
May 27, 2014·Frontiers in Human Neuroscience·Valentina La ScaleiaFrancesco Lacquaniti

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