Idiopathic toe-walking: does treatment alter the natural history?
Outcomes from observation or cast or surgical treatment of idiopathic toe-walking were determined in 136 children. With patient-determined outcomes, for the observation group, gait was normal in 6%, improved in 45%, and unchanged in 49%. Physician-determined outcomes demonstrated normal gait in 12% of children. Outcomes were similar in the cast group. With patient-determined outcomes in the surgical group, 22% walked normally, 50% had improved, 26% were unchanged, and 2% had deteriorated; with physician-determined outcomes, 37% walked normally. The natural history, determined from the observation group, was for idiopathic toe-walking to persist, albeit with improvement in 50%. Cast treatment did not alter the natural history. Surgical treatment may influence the outcome, but indications for surgery need to be clarified.
Eastwood
D M
DM
Department of Orthopaedics, Royal Children's Hospital, Victoria, Australia.
Menelaus
M B
MB
Dickens
D R
DR
Broughton
N S
NS
Cole
W G
WG
D000125:Achilles Tendon / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005684:Gait; D006801:Humans; D007223:Infant; D008297:Male; D014034:Toes; D016896:Treatment Outcome